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General NPI Number Information
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NPI Number | 1174729842
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Entity Type | Organization
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Legal Business Name | THE ENDOCRINE DOCTOR INC.
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 315 E NORTHFIELD RD SUITE 1C
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City | LIVINGSTON
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State | NJ
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Zip | 07039-4896
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Country | US
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Telephone | 973-992-1118
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Fax | 973-992-3050
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Provider Business Mailing Address
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Address Line | 315 E NORTHFIELD RD SUITE 1C
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City | LIVINGSTON
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State | NJ
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Zip | 07039-4896
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Country | US
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Telephone | 973-992-1118
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Fax | 973-992-3050
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Authorized Official
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Title or Position | PRESIDENT
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Name | SONOO ADVANI
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Credential | M.D.
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Telephone | 973-992-1118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MA068064
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License Number State | NJ
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