Provider Demographics
NPI:1770542151
Name:FIGUEROA, JORGE J (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:J
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 VISTA TRAIL
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470
Mailing Address - Country:US
Mailing Address - Phone:201-770-9995
Mailing Address - Fax:201-770-9996
Practice Address - Street 1:433 60TH ST
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-2211
Practice Address - Country:US
Practice Address - Phone:201-770-9995
Practice Address - Fax:201-770-9996
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA67655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8353409Medicaid
NJ111158Medicare PIN
NJ8353409Medicaid
NJG83389Medicare UPIN