Healthcare Provider Details

I. General information

NPI: 1356302186
Provider Name (Legal Business Name): JULIO H URENA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 06/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 UNION AVE
CLIFTON NJ
07011-2219
US

IV. Provider business mailing address

40 UNION AVE
CLIFTON NJ
07011-2219
US

V. Phone/Fax

Practice location:
  • Phone: 973-574-0010
  • Fax: 973-574-0031
Mailing address:
  • Phone: 973-574-0010
  • Fax: 973-574-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA58979
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: