Vivian K. Bethala, MD PA

NPI #1568412799 in Emerson, New Jersey

Provider Information

NPI Number: 1568412799
Entity Type: Organization
Organization Name: Vivian K. Bethala, MD PA
Primary Specialty: Specialist
Enumeration Date: May 10, 2006
Last Updated: Dec 2, 2016

Practice Location

Address: 466 OLD HOOK RD
Address 2: SUITE 9
City: Emerson
State: New Jersey
ZIP Code: 07630-1396
Phone: (201) 261-1005

Authorized Official

Name: DR. VIVIAN K BETHALA, MD
Title: PRESIDENT
Phone: (201) 261-1005

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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