| Jesus Alfonso | |
|
7907 Kennedy Blvd North Bergen NJ 07047-4137 | |
| (201) 330-8747 | |
| (201) 330-8947 |
| Full Name | Jesus Alfonso |
|---|---|
| Speciality | Internal Medicine |
| Location | 7907 Kennedy Blvd, North Bergen, New Jersey |
| Authorized Official Name and Position | Jesus Alfonso (OWNER) |
| Authorized Official Contact | 2013308747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jesus Alfonso 7907 Kennedy Blvd North Bergen NJ 07047-4137 Ph: (201) 330-8747 | Jesus Alfonso 7907 Kennedy Blvd North Bergen NJ 07047-4137 Ph: (201) 330-8747 |
| NPI Number | 1386824308 |
|---|---|
| Provider Enumeration Date | 11/07/2007 |
| Last Update Date | 11/07/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386824308 | NPI | - | NPPES |
| JA3410307 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA05064100 (New Jersey) | Primary |
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