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General NPI Number Information
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NPI Number | 1023418779
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Entity Type | Organization
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Legal Business Name | COMPLETE ENDOCRINOLOGY AND THYROID CENTER LLC
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Dates
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Enumeration Date | 08/31/2014
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Last Update Date | 12/18/2014
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Provider Practice Location Address
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Address Line | 330 RATZER RD SUITE D-17
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City | WAYNE
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State | NJ
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Zip | 07470-7702
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Country | US
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Telephone | 973-832-7487
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Fax | 973-832-7489
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Provider Business Mailing Address
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Address Line | 330 RATZER RD SUITE D-17
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City | WAYNE
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State | NJ
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Zip | 07470-7702
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Country | US
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Telephone | 973-832-7487
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Fax | 973-832-7489
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JAMES PING-HSUN LEU
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Credential | M.D.
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Telephone | 973-832-7487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 25MA08383200
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License Number State | NJ
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