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General NPI Number Information
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NPI Number | 1548647878
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Entity Type | Organization
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Legal Business Name | DIABETES & THYROID ENDOCRINOLOGY CENTER PC
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 180 WHITE RD STE 205
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City | LITTLE SILVER
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State | NJ
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Zip | 07739-1166
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Country | US
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Telephone | 732-939-1485
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Fax | 732-939-1485
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Provider Business Mailing Address
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Address Line | 181 WOODCLIFF BLVD
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City | MORGANVILLE
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State | NJ
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Zip | 07751-4226
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Country | US
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Telephone | 732-939-1485
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Fax | 732-939-1485
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RITU MALIK
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Credential | MD
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Telephone | 716-531-3048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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