Healthcare Provider Details

I. General information

NPI: 1417902271
Provider Name (Legal Business Name): CARMEN DELCUETO MD & ASSOCIATE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121B NEW YORK AVE
UNION CITY NJ
07087-4927
US

IV. Provider business mailing address

4121B NEW YORK AVE
UNION CITY NJ
07087-4927
US

V. Phone/Fax

Practice location:
  • Phone: 201-319-9722
  • Fax: 201-319-1707
Mailing address:
  • Phone: 201-319-9722
  • Fax: 201-319-1707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MS. MARTA DELGADO
Title or Position: VICE PRESIDENT
Credential:
Phone: 201-319-9722