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General NPI Number Information
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NPI Number | 1114285459
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Entity Type | Organization
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Legal Business Name | ARMOUR BREAST SURGERY LLC
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 900 W MAIN ST SUITE 4
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City | FREEHOLD
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State | NJ
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Zip | 07728-2523
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Country | US
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Telephone | 732-414-6800
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Fax | 732-414-6803
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Provider Business Mailing Address
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Address Line | 900 W MAIN ST SUITE 4
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City | FREEHOLD
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State | NJ
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Zip | 07728-2523
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Country | US
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Telephone | 732-414-6800
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Fax | 732-414-6803
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. RENEE P ARMOUR
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Credential | MD
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Telephone | 732-414-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA07197700
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License Number State | NJ
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