Healthcare Provider Details

I. General information

NPI: 1679319644
Provider Name (Legal Business Name): ALBERTO JOSE GARCIA SAUCEDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

100 FRANKLIN ST APT 104C
MORRISTOWN NJ
07960-5437
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5000
  • Fax:
Mailing address:
  • Phone: 602-900-2934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number000000000000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: