Provider Demographics
NPI:1952734642
Name:EASTERN NEONATOLOGY LLC
Entity Type:Organization
Organization Name:EASTERN NEONATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:MUSTAFA
Authorized Official - Last Name:ZAUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-754-2555
Mailing Address - Street 1:PO BOX 461
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-0461
Mailing Address - Country:US
Mailing Address - Phone:973-754-2555
Mailing Address - Fax:973-754-2567
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2555
Practice Address - Fax:973-754-2567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-16
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty