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General NPI Number Information
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NPI Number | 1013092071
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Entity Type | Organization
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Legal Business Name | SPECIALTY MD INC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 906 OAK TREE AVE SUITE J
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City | SOUTH PLAINFIELD
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State | NJ
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Zip | 07080-5127
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Country | US
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Telephone | 908-222-3506
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Fax | 908-222-8770
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Provider Business Mailing Address
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Address Line | 1308 CENTENNIAL AVE SUITE 350
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City | PISCATAWAY
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State | NJ
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Zip | 08854
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Country | US
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Telephone | 908-222-3506
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Fax | 908-222-8770
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. ZENITH YLANAN
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Credential | RN
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Telephone | 908-222-3506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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