Individual
GE MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
365 OSBORNE TER, 1ST FLOOR, NEWARK, NJ 07112
(973) 926-7224
Mailing address
379 CAMPUS DR FL 4, SOMERSET, NJ 08873-1161
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
25MA09874200
NJ
2083X0100X
Occupational Medicine Physician
MD458521
PA
Other
Enumeration date
08/12/2013
Last updated
06/06/2024
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