Provider Demographics
NPI:1609114628
Name:UNIVERSITY MEDICAL OFFICE NJ, LLC
Entity Type:Organization
Organization Name:UNIVERSITY MEDICAL OFFICE NJ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:ARTURO
Authorized Official - Last Name:BELLIARD ESTEVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:551-333-3456
Mailing Address - Street 1:56 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3554
Mailing Address - Country:US
Mailing Address - Phone:551-333-3456
Mailing Address - Fax:646-393-9081
Practice Address - Street 1:56 LINDEN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3554
Practice Address - Country:US
Practice Address - Phone:551-333-3456
Practice Address - Fax:646-393-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08476500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty