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General NPI Number Information
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NPI Number | 1578698700
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Entity Type | Organization
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Legal Business Name | MEDICAL SPECIALTIES OF NEW JERSEY PA
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 842 CLIFTON AVE SUITE 4
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City | CLIFTON
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State | NJ
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Zip | 07013-1800
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Country | US
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Telephone | 973-777-2440
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Fax |
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Provider Business Mailing Address
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Address Line | 842 CLIFTON AVE SUITE 4
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City | CLIFTON
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State | NJ
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Zip | 07013-1800
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Country | US
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Telephone | 973-777-2440
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GABRIELLA ANTOINETTE WEISS
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Credential | MD
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Telephone | 973-777-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MA42491
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License Number State | NJ
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