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General NPI Number Information
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NPI Number | 1447804059
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Entity Type | Organization
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Legal Business Name | ALTEON HEALTH NEW JERSEY IC PC
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 727 N BEERS ST
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City | HOLMDEL
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State | NJ
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Zip | 07733-1514
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Country | US
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Telephone | 240-686-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 12420 MILESTONE CENTER DR STE 200
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City | GERMANTOWN
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State | MD
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Zip | 20876-7111
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Country | US
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Telephone | 240-686-2300
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Fax |
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Authorized Official
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Title or Position | CHIEF REVENUE OFFICER
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Name | MICHAEL HITE
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Credential |
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Telephone | 240-686-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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