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General NPI Number Information
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NPI Number | 1124341110
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Entity Type | Organization
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Legal Business Name | MONROE KARETZKY, MD, P.A.
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Dates
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Enumeration Date | 03/05/2010
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 200 ENGLE ST SUITE 10
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2440
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Country | US
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Telephone | 201-596-0404
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Fax | 201-569-0422
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Provider Business Mailing Address
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Address Line | 200 ENGLE ST SUITE 10
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2440
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Country | US
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Telephone | 201-596-0404
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Fax | 201-569-0422
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Authorized Official
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Title or Position | OWNER
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Name | MONROE KARETZKY
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Credential | M.D.
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Telephone | 201-569-0404
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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 | 25MA02871700
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License Number State | NJ
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