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General NPI Number Information
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NPI Number | 1356505127
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Entity Type | Organization
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Legal Business Name | NEW LIFE RHEUMATOLOGY CENTER LLC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 889 ALLWOOD RD
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City | CLIFTON
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State | NJ
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Zip | 07012-1933
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Country | US
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Telephone | 973-778-6800
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Fax | 973-653-3028
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Provider Business Mailing Address
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Address Line | 889 ALLWOOD RD
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City | CLIFTON
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State | NJ
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Zip | 07012-1933
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Country | US
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Telephone | 973-778-6800
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Fax | 973-653-3028
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Authorized Official
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Title or Position | RHEUMATOLOGYST
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Name | DR. ALICE CHU
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Credential | MD
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Telephone | 973-778-6800
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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 | 25MA06229000
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License Number State | NJ
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