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General NPI Number Information
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NPI Number | 1871154906
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Entity Type | Organization
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Legal Business Name | NORTHEASTERN MEDICAL NETWORK L.L.C.
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 124-8 AVE ROBERTO CLEMENTE
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-750-4920
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Fax | 787-276-4275
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Provider Business Mailing Address
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Address Line | PO BOX 3628
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City | CAROLINA
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State | PR
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Zip | 00984-3628
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Country | US
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Telephone | 787-750-4920
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Fax | 787-276-4275
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORGE F HESS
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Credential | MD
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Telephone | 787-642-3232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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