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General NPI Number Information
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NPI Number | 1134493489
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Entity Type | Organization
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Legal Business Name | CNIJ
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 195 LITTLE ALBANY ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1914
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Country | US
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Telephone | 732-235-9839
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Fax | 732-235-9831
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Provider Business Mailing Address
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Address Line | 195 LITTLE ALBANY ST
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1914
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Country | US
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Telephone | 732-235-9839
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Fax | 732-235-9831
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Authorized Official
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Title or Position | APN
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Name | MRS. NATALIE DENISE RALPH-NELSON
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Credential | APN
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Telephone | 732-235-9839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 26NJ00320200
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License Number State | NJ
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