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NPI Code Detail

MEDICARE: DR. MARCELO NABONG JR. M.D.

MEDICARE: DR. MARCELO NABONG JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080N0001XNeonatal-Perinatal Medicine Physician223566NY
22080N0001XNeonatal-Perinatal Medicine Physician25MA07477300NJ

General Provider Information

NPI Number : 1669415600
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCELO NABONG JR. M.D.
Provider Business Mailing Address
First Line : 204 MCELROY AVE
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-4312
Country : US
Telephone Number : 201-886-1328
Fax Number :
Provider Business Practice Location Address
First Line : 1400 PELHAM PKWY S
Second Line :
City : BRONX
State : NY
Zip : 10461-1197
Country : US
Telephone Number : 718-918-7003
Fax Number : 718-918-6460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 02/21/2024

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