Jose R Antillon
M.D. | Pediatric Cardiology | Male
Jose R Antillon, M.D. is a Newark, New Jersey based Pediatric doctor with medical specialization in
Pediatric Cardiology.
Current practice location of Jose R Antillon is
90 Bergen St, Doc 5100, Newark, New Jersey - 07103-2425. He can be contacted on phone at
973-972-5779 and fax number 973-972-5895.
Jose R Antillon is a sole proprietor of his business.
NPI number (Unique professional ID) for Jose R Antillon is
1114134715 which was assigned by NPPES on 16 May, 2007 and it was last updated on 14 Aug, 2009.
Jose R Antillon license number is
25MA02220500 for Pediatrics Pediatric Cardiology (2080P0202X) in New Jersey.
Jose R Antillon provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Complete Profile:
Jose R Antillon basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Cardiology |
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| Provider Name : | Jose R Antillon |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Jose R Antillon address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 90 Bergen St, Doc 5100
Newark, NJ, 07103-2425
United States |
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| Phone Number : | 973-972-5779 |
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| Fax Number : | 973-972-5895 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1114134715 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 16 May, 2007 |
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| Last Updated On : | 14 Aug, 2009 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jose R Antillon are as mentioned. Primary taxonomy code for Jose R Antillon, M.D. is
2080P0202X (Pediatrics Pediatric Cardiology).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080P0202X | Pediatrics Pediatric Cardiology | Yes | 25MA02220500 | NJ |
Legacy Identifiers:
Other legacy medical identifiers of Jose R Antillon such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 1595504 | MEDICAID | NJ | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 30 Bergen St, Admc 12 1205
Newark, NJ, 07107-3000
United States |
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Business Location:
Patients can refer following map for directions to
Jose R Antillon practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.