Healthcare Provider Details

I. General information

NPI: 1215037270
Provider Name (Legal Business Name): JOSE M. ARRUNATEGUI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 08/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 WESTFIELD AVE
ELIZABETH NJ
07208-1327
US

IV. Provider business mailing address

717 WESTFIELD AVE
ELIZABETH NJ
07208
US

V. Phone/Fax

Practice location:
  • Phone: 908-353-7500
  • Fax: 908-353-8590
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA05771800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: