Provider Demographics
NPI:1770755159
Name:JOHN DRULLE MD & EMILIA EIRAS MD PC
Entity type:Organization
Organization Name:JOHN DRULLE MD & EMILIA EIRAS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:EIRAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-905-9630
Mailing Address - Street 1:702 BREWERS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2020
Mailing Address - Country:US
Mailing Address - Phone:732-905-9630
Mailing Address - Fax:732-905-0837
Practice Address - Street 1:702 BREWERS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2020
Practice Address - Country:US
Practice Address - Phone:732-905-9630
Practice Address - Fax:732-905-0837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA40189207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty