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General NPI Number Information
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NPI Number | 1205910890
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Entity Type | Organization
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Legal Business Name | HUNTERDON ENDOCRINOLOGY AND DIABETES
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 121 STATE ROUTE 31 SUITE 300
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City | FLEMINGTON
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State | NJ
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Zip | 08822-5744
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Country | US
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Telephone | 908-788-8111
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Fax | 908-788-8120
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Provider Business Mailing Address
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Address Line | 121 STATE ROUTE 31 SUITE 300
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City | FLEMINGTON
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State | NJ
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Zip | 08822-5744
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Country | US
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Telephone | 908-788-8111
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Fax | 908-788-8180
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WANDA D RYAN
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Credential | MD
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Telephone | 908-788-8111
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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 | MA67670
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License Number State | NJ
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