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General NPI Number Information
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NPI Number | 1508284605
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Entity Type | Organization
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Legal Business Name | M.J. CHIUMENTO ASSOCIATES LLC
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Dates
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Enumeration Date | 04/04/2014
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 20 COMMUNITY PL STE 105
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7501
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Country | US
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Telephone | 973-538-4544
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Fax | 973-538-3703
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Provider Business Mailing Address
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Address Line | 20 COMMUNITY PL STE 105
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7501
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Country | US
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Telephone | 973-538-4544
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Fax | 973-538-3703
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARVIN J CHIUMENTO
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Credential | M.D.
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Telephone | 973-538-4544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 25MA07226800
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License Number State | NJ
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