Organization
RUTGERS HEALTH-PCC MONUMENT SQUARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA WALTER (PROVIDER ENROLLMENT MANAGER)
(732) 212-0051
Entity
Organization
Contact information
Practice address
317 GEORGE ST, FIRST FLOOR, NEW BRUNSWICK, NJ 08901-2008
(732) 235-8993
Mailing address
66 WEST GILBERT ST, RED BANK, NJ 07701
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6602801
—
NJ
Enumeration date
10/20/2006
Last updated
07/11/2017
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