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General NPI Number Information
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NPI Number | 1336473941
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Entity Type | Organization
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Legal Business Name | FLJ & M MEDICAL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/29/2009
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 115 RIVER RD STE 305
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City | EDGEWATER
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State | NJ
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Zip | 07020-1009
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Country | US
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Telephone | 201-941-4405
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Fax | 201-941-4408
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Provider Business Mailing Address
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Address Line | 353 EAST HARRIET AVENUE
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City | PALISADES PARK
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State | NJ
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Zip | 07650
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Country | US
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Telephone | 201-941-4405
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Fax | 201-941-4408
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK SANTOS
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Credential | MD
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Telephone | 201-941-4405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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