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General NPI Number Information
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NPI Number | 1942217328
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Entity Type | Individual
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Provider Name | EMMANUEL HRISO MD
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 54 MAIN ST
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2816
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Country | US
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Telephone | 732-855-1199
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Fax | 732-855-1138
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Provider Business Mailing Address
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Address Line | 380 MOUNTAIN RD APT 1003
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City | UNION CITY
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State | NJ
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Zip | 07087-7306
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Country | US
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Telephone | 201-436-4080
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Fax | 201-436-1601
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MA47778
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License Number State | NJ
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