Total Healthcare Of Hawthorne LLC
Internal Medicine in Hawthorne, NJ. Organization (NPI-2).
NPI number1982967758
StatusActive
Last updated in NPPESSep 27, 2013
Details
- NPI
- 1982967758
- Entity type
- Organization (NPI-2)
- Legal business name
- Total Healthcare Of Hawthorne LLC
- Organization subpart
- No
- Enumeration date
- Jun 18, 2012
- Last updated
- Sep 27, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA07806100 | NJ | Yes |
| 207RC0000X | Internal Medicine, Cardiovascular Disease | – | – | |
| 207RG0100X | Internal Medicine, Gastroenterology | – | – | |
| 213E00000X | Podiatrist | – | – |
Practice location
219 Lafayette AveHawthorne, NJ 07506-1904
Phone 201-543-9992
Mailing address
Po Box 4157River Edge, NJ 07661-4157
Phone 201-543-9992
Authorized official
Luis Fredy Luna
Physician
2015439992
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