Healthcare Provider Details

I. General information

NPI: 1285678045
Provider Name (Legal Business Name): RAUL ALLAREY LIMJUCO M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 11/05/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 NEW DOVER RD
COLONIA NJ
07067-2607
US

IV. Provider business mailing address

411 NEW DOVER RD
COLONIA NJ
07067-2607
US

V. Phone/Fax

Practice location:
  • Phone: 732-388-9269
  • Fax:
Mailing address:
  • Phone: 732-388-9269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA03433100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: