Provider Demographics
NPI:1851420459
Name:JORGE J FIGUEROA MD LLC
Entity Type:Organization
Organization Name:JORGE J FIGUEROA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-770-9995
Mailing Address - Street 1:10 OVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6282
Mailing Address - Country:US
Mailing Address - Phone:201-770-9995
Mailing Address - Fax:201-770-9996
Practice Address - Street 1:5600 KENNEDY BLVD W
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1256
Practice Address - Country:US
Practice Address - Phone:201-770-9995
Practice Address - Fax:201-770-9996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA67655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7468002Medicaid
NJG83389Medicare UPIN
NJ021621Medicare ID - Type Unspecified