Organization Name: | CLIFTON WALLINGTON MEDICAL GROPU |
NPI Number: | 1124103973 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY DEVIRGILIO (BILLING MANANGER) |
Mailing Address: | 1033 Clifton Ave Suite 210 Clifton |
State: | NJ US |
Postal Code: | 070133517 |
Phone Number: | 9734734624 |
Fax Number: | 9734764547 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA05999500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |