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General NPI Number Information
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NPI Number | 1023366960
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Entity Type | Organization
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Legal Business Name | NJ NY MANAGEMENT, PC
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Dates
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Enumeration Date | 08/27/2012
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 777 TERRACE AVE FL 4
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City | HASBROUCK HEIGHTS
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State | NJ
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Zip | 07604-3107
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Country | US
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Telephone | 800-985-7509
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Fax |
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Provider Business Mailing Address
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Address Line | 777 TERRACE AVE FL 4
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City | HASBROUCK HEIGHTS
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State | NJ
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Zip | 07604-3107
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAMON NOTO
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Credential |
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Telephone | 800-985-7509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 220474
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA07789800
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License Number State | NJ
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