Healthcare Provider Details

I. General information

NPI: 1972737104
Provider Name (Legal Business Name): RWJ AOI (RETEIRED)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WASHINGTON BLVD SUITE A
TRENTON NJ
08691-3162
US

IV. Provider business mailing address

1 WASHINGTON BLVD SUITE A
TRENTON NJ
08691-3162
US

V. Phone/Fax

Practice location:
  • Phone: 303-717-9714
  • Fax: 303-894-8066
Mailing address:
  • Phone: 303-717-9714
  • Fax: 303-894-8066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCO JAVIER VILLOTA
Title or Position: PHYSICIAN
Credential: MD
Phone: 609-406-0671