Healthcare Provider Details
I. General information
NPI: 1861676348
Provider Name (Legal Business Name): CATHEDRAL BLOOD RESEARCH INSTITUTE PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/20/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
268 DR. MARTIN LUTHER KING BOULEVARD
NEWARK NJ
07102-2094
US
IV. Provider business mailing address
66 W GILBERT ST 2ND FLOOR
RED BANK NJ
07701-4819
US
V. Phone/Fax
- Phone: 973-877-5527
- Fax:
- Phone: 732-212-0051
- Fax: 732-212-0052
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
FRANCES
FLUG
Title or Position: MANAGING PHYSICIAN
Credential: MD
Phone: 973-877-5000