| Na | |
|
7 Januson Ct West Orange NJ 07052-3657 | |
| (973) 736-8212 | |
| (973) 736-0645 |
| Full Name | Na |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 7 Januson Ct, West Orange, New Jersey |
| Authorized Official Name and Position | Rowen Gumapas Diano (PRESIDENT) |
| Authorized Official Contact | 9737368212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Na 7 Januson Ct West Orange NJ 07052-3657 Ph: (973) 736-8212 | Na 7 Januson Ct West Orange NJ 07052-3657 Ph: (973) 736-8212 |
| NPI Number | 1205957180 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205957180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | MA 69300 (New Jersey) | Primary |
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