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General NPI Number Information
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NPI Number | 1538198486
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Entity Type | Organization
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Legal Business Name | KIDNEY AND HYPERTENSION SPECIALISTS, P.A.
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 20 MAGNOLIA AVE SUITE A
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City | BRIDGETON
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State | NJ
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Zip | 08302-1759
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Country | US
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Telephone | 856-455-6002
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Fax | 856-455-6106
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Provider Business Mailing Address
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Address Line | 20 MAGNOLIA AVE SUITE A
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City | BRIDGETON
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State | NJ
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Zip | 08302-1759
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Country | US
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Telephone | 856-455-6002
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Fax | 856-455-6106
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELIS M. PRIORI
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Credential | MD
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Telephone | 856-455-6002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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