Healthcare Provider Details
I. General information
NPI: 1942275078
Provider Name (Legal Business Name): CLAUDE MACAJOUX MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/22/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
151 WASHINGTON ST
NEWARK NJ
07102-3026
US
IV. Provider business mailing address
30 FUNDUS RD
WEST ORANGE NJ
07052-3511
US
V. Phone/Fax
- Phone: 973-622-3900
- Fax: 973-622-1698
- Phone: 973-731-0965
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 25MA02833100 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | 25MA02833100 |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0005X |
| Taxonomy | Ambulatory Family Planning Facility |
| License Number | 25MA02833100 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: