Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2013-01-09
- Last updated
- 2013-01-09
Specialties
Licenses
- License NJ
- 31D2043848
Location
- Practice location
- 1975 HIGHWAY 34 SOUTH
- City
- WALL NJ
- Postal code
- 07719
- Phone
- 732-974-8060
Organization contact
- Name
- JEFFREY DIPAOLO
- Title
- Medical Director
- Phone
- 7329748060
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.