1235245531 NPI number — MRS. LOURDES SANTOS DUQUE APN

Table of content: MRS. LOURDES SANTOS DUQUE APN (NPI 1235245531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235245531 NPI number — MRS. LOURDES SANTOS DUQUE APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUQUE
Provider First Name:
LOURDES
Provider Middle Name:
SANTOS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235245531
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2233 RHODA PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTCH PLAINS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07076-1353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-228-2359
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
385 TREMONT AVE
Provider Second Line Business Practice Location Address:
SECTION HEMATOLOGY-ONCOLOGY
Provider Business Practice Location Address City Name:
EAST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07018-1023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-676-1000
Provider Business Practice Location Address Fax Number:
973-395-7089
Provider Enumeration Date:
08/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)