| Doctor Name: | DR. EDSEL ANTONIO |
| NPI Number: | 1265790752 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 25MB09742100 |
| Business Practice Address: | 201 Lyons Ave Ob/gyn Dept Newark, NJ - 071122027 |
| Business Phone Number: | 9739264882 |
| Business Fax Number: | |
| Mailing Address: | 120 Irvington Ave, SOUTH ORANGE |
| State: | NJ |
| Postal Code: | 070791904 |
| Phone Number: | 9737627270 |
| Fax Number: | 9737621980 |
| NPI Enumeration Date: | 05/02/2012 |
| NPI Last Update Date: | 08/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 25MB09742100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |