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General NPI Number Information
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NPI Number | 1457346918
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Entity Type | Individual
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Provider Name | ALFONSO CIERVO MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 142 HIGHWAY 35 SUITE 106A
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City | EATONTOWN
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State | NJ
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Zip | 07724-3427
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Country | US
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Telephone | 732-380-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CRAPE MYRTLE DR
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City | HOLMDEL
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State | NJ
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Zip | 07733-1529
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Country | US
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Telephone | 732-380-1222
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 25MA06756800
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License Number State | NJ
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