PRO FORM SPORTS MEDICINE AND WELLNESS ASSOCIATES
Organization (NPI-2)
Active
Emergency Medicine, Sports Medicine
Provider Information
- NPI Number
1235432972- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 201 ROUTE 17 11TH FLOOR, RUTHERFORD, NJ, 070702574
- Phone
- (201) 549-8846
- Fax
- (201) 549-8839
Specialties & Taxonomies
Emergency Medicine, Sports Medicine
Primary License: NJ #25MA08835000