Organization · NPI-2

321 Summit Medical

Internal Medicine · Hackensack, NJ

NPI number1679865109
StatusActive
Last updated in NPPESMay 3, 2011

Details

NPI
1679865109
Entity type
Organization (NPI-2)
Legal business name
321 Summit Medical
Organization subpart
No
Enumeration date
May 3, 2011
Last updated
May 3, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

321 Summit Ave
Hackensack, NJ 07601-1429

Phone 201-343-2434 · Fax 201-343-3917

Mailing address

321 Summit Ave
Hackensack, NJ 07601-1429

Phone 201-343-2434 · Fax 201-343-3917

Authorized official

Charles S Davis
President
2013432434

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