Healthcare Provider Details

I. General information

NPI: 1699377978
Provider Name (Legal Business Name): NUNEZ MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 W RAILROAD AVE
TENAFLY NJ
07670-2093
US

IV. Provider business mailing address

15 W RAILROAD AVE
TENAFLY NJ
07670-2093
US

V. Phone/Fax

Practice location:
  • Phone: 201-208-7201
  • Fax: 231-216-7579
Mailing address:
  • Phone: 201-208-7201
  • Fax: 231-216-7579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RANDOLPH NUNEZ
Title or Position: CEO
Credential: MD
Phone: 201-208-7201