Individual
DR. EDMUNDO C DE VERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5301 BROADWAY, WEST NEW YORK, NJ 07093-2622
(201) 866-9320
Mailing address
211 W ELMWOOD DR, SOUTH PLAINFIELD, NJ 07080-4914
(908) 755-9731
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MAO 61048
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6346502
—
NJ
Enumeration date
04/26/2006
Last updated
03/14/2012
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