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General NPI Number Information
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NPI Number | 1598275141
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Entity Type | Organization
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Legal Business Name | FJPL EAST ORANGE PC
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 276 PROSPECT ST
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City | EAST ORANGE
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State | NJ
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Zip | 07017-2889
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Country | US
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Telephone | 973-000-0000
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Fax | 862-904-0044
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Provider Business Mailing Address
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Address Line | 110 SQUIRE HILL RD
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City | MONTCLAIR
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State | NJ
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Zip | 07043-2516
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Country | US
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Telephone | 973-370-4000
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. HR MANAGER
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Credential |
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Telephone | 973-000-0000
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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 | 25MA08818300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA08818300
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License Number State | NJ
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