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General NPI Number Information
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NPI Number | 1982996849
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Entity Type | Organization
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Legal Business Name | TREVOR H. ATHERLEY M.D., PA
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 05/11/2011
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Provider Practice Location Address
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Address Line | 201 LYONS AVE L3
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City | NEWARK
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State | NJ
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Zip | 07112-2027
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Country | US
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Telephone | 973-926-7323
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Fax |
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Provider Business Mailing Address
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Address Line | 201 LYONS AVE L3
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City | NEWARK
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State | NJ
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Zip | 07112-2027
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Country | US
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Telephone | 973-926-7323
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TREVOR H ATHERLEY
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Credential |
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Telephone | 973-926-7323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA03116600
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License Number State | NJ
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