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General NPI Number Information
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NPI Number | 1669882312
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Entity Type | Organization
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Legal Business Name | MEDICINE SANS FRONTIER
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Dates
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Enumeration Date | 05/03/2014
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Last Update Date | 05/03/2014
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Provider Practice Location Address
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Address Line | 12 MORRIS AVE
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City | SUMMIT
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State | NJ
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Zip | 07901-3920
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Country | US
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Telephone | 908-273-5954
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Fax |
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Provider Business Mailing Address
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Address Line | 12 MORRIS AVE
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City | SUMMIT
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State | NJ
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Zip | 07901-3920
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Country | US
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Telephone | 908-273-5954
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. GIOACCHINO AJ PATUTO
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Credential | M.D.
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Telephone | 908-273-5954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 107-1078
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License Number State | ZZ
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