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Organization

NBIMC-FP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GALINA M BEGUN CPCS, CPMSM (CREDENTIALING MANAGER)
(732) 557-7119
Entity
Organization

Contact information

Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-7475
(973) 318-7207
Mailing address
201 LYONS AVE, L5, NEWARK, NJ 07112-2027
(732) 557-7119
(732) 557-7109

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207V00000X
Obstetrics & Gynecology Physician
208000000X
Pediatrics Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02166003
NY
Enumeration date
01/24/2008
Last updated
01/24/2008
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