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General NPI Number Information
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NPI Number | 1801923248
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Entity Type | Organization
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Legal Business Name | RRGB HOLDING LLC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 345 HENRY ST STE 106
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City | ORANGE
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State | NJ
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Zip | 07050-2500
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Country | US
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Telephone | 973-678-5784
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Fax |
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Provider Business Mailing Address
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Address Line | 1 AZALEA TRL
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City | WESTFIELD
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State | NJ
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Zip | 07090-1684
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Country | US
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Telephone | 908-654-7224
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MRS. UMA J BARAI
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Credential |
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Telephone | 908-654-7224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 31166
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License Number State | NJ
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