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General NPI Number Information
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NPI Number | 1669734117
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Entity Type | Individual
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Provider Name | ELIZABETH VERDUZCO D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 113 14TH ST
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City | HOBOKEN
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State | NJ
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Zip | 07030-5545
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Country | US
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Telephone | 201-795-8596
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Fax |
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Provider Business Mailing Address
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Address Line | 6 ROMA ST
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City | SAYREVILLE
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State | NJ
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Zip | 08872-1724
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Country | US
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Telephone | 551-225-5314
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MB09611700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 290305-1
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License Number State | NY
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