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General NPI Number Information
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NPI Number | 1477787737
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MEDICINE AND DENSITRY
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 05/14/2009
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Provider Practice Location Address
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Address Line | 65 BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07107-3001
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Country | US
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Telephone | 973-972-9793
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Fax | 973-972-7904
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Provider Business Mailing Address
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Address Line | 65 BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07107-3001
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Country | US
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Telephone | 973-972-9793
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Fax | 973-972-7904
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Authorized Official
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Title or Position | ASSISTANT DEAN
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Name | DR. MARY KAMIENSKI
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Credential | PHD, APN
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Telephone | 973-972-7451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 26NR09200200
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License Number State | NJ
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