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General NPI Number Information
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NPI Number | 1033198494
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE MEDRANO M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 55 CORPORATE DR MAIL STOP 55C-B-100A
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-1265
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Country | US
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Telephone | 908-981-6925
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Fax | 908-306-9010
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Provider Business Mailing Address
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Address Line | 242 MCAULIFFE CT
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City | SOMERSET
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State | NJ
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Zip | 08873-1767
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Country | US
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Telephone | 732-429-4135
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA07805500
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License Number State | NJ
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