South Orange Village Medical Group, LLC

NPI #1164716544 in South Orange, New Jersey

Provider Information

NPI Number: 1164716544
Entity Type: Organization
Organization Name: South Orange Village Medical Group, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jun 3, 2011
Last Updated: Jun 3, 2011

Practice Location

Address: 483 S ORANGE AVE
City: South Orange
State: New Jersey
ZIP Code: 07079-2642
Phone: (973) 638-1634

Authorized Official

Name: MR. AMGAD HESSEIN, MD
Title: OWNER
Phone: (973) 638-1634

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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