| Organization Name: | DEWI S. SUDJONO-SANTOSO |
| NPI Number: | 1124417639 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEWI S SUDJONO-SANTOSO (OWNER) |
| Mailing Address: | 339 Princeton-hightstown Rd Building B Cranbury |
| State: | NJ US |
| Postal Code: | 08512 |
| Phone Number: | 6099181030 |
| Fax Number: | 6099181322 |
| NPI Enumeration Date: | 01/21/2015 |
| NPI Last Update Date: | 01/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080A0000X |
| License Number: | MA01513300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |