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General NPI Number Information
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NPI Number | 1396352993
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Entity Type | Organization
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Legal Business Name | MAEZ INTEGRATIVE HEALTHCARE, LLC
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 200 NEW RD
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City | LINWOOD
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State | NJ
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Zip | 08221-1306
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Country | US
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Telephone | 609-748-4199
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Fax | 609-748-4112
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Provider Business Mailing Address
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Address Line | 200 NEW RD
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City | LINWOOD
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State | NJ
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Zip | 08221-1306
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Country | US
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Telephone | 609-748-4199
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Fax | 609-748-4112
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Authorized Official
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Title or Position | M.D.
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Name | MARY N ONWUKA
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Credential | M.D.
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Telephone | 609-748-4199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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