Provider Information for 1013673805
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SUGARRX INC
Organization Subpart: NO
NPI: 1013673805
Last Updated: 2022-05-16
Certification Date: 2022-05-16
Certification Date: 2022-05-16
Details
Name | Value | ||||||||||||||||
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NPI | 1013673805 | ||||||||||||||||
Enumeration Date | 2021-11-16 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
Authorized Official Information | Name: Dr. GABRIELA BERNAT Title: PRESIDENT Phone: 2018676705 | ||||||||||||||||
Mailing Address | 4207 BERGENLINE AVENUE UNION CITY, NJ 07087 United States Phone: 201-867-6705 | Fax:201-867-3758 | ||||||||||||||||
Primary Practice Address | 4207 BERGENLINE AVENUE UNION CITY, NJ 07087 United States Phone: 201-867-6705 | Fax:201-867-3758 | ||||||||||||||||
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