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General NPI Number Information
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NPI Number | 1982136958
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Entity Type | Organization
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Legal Business Name | DRS MEDICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 150 BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07103-2496
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Country | US
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Telephone | 973-972-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 117 BIRCHWOOD TER
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City | CLIFTON
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State | NJ
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Zip | 07012-2333
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAY SANTOS
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Credential | MD
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Telephone | 201-706-3808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00540300
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License Number State | NJ
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