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Vivian K. Bethala, Md Pa
Specialist in Emerson, New Jersey
NPI 1568412799

Vivian K. Bethala, Md Pa is a Specialist based in Emerson, NJ. Vivian K. Bethala, Md Pa practices in Emerson, NJ. The NPI Number for Vivian K. Bethala, Md Pa is 1568412799 and holds a License No. 25MA0371400 (New Jersey).

The current practice location address for Vivian K. Bethala, Md Pa is 466 Old Hook Rd, Emerson, NJ and can be reached out via phone at 201-261-1005 and via fax at 201-261-4208.

Location: 466 Old Hook Rd, Emerson, NJ, 07630-1396
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1568412799
Provider Name
Vivian K. Bethala, Md Pa
Credential
Provider Entity Type
Organization
Address
466 Old Hook Rd, Emerson, NJ, 07630-1396
Phone Number
201-261-1005
Fax Number
201-261-4208
Provider Enumeration Date
05/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4906403 05 NJ
institution
Provider Business Practice Location Address Details
Address
466 Old Hook Rd
City
Emerson
State
New Jersey
Zip
07630-1396
Phone Number
201-261-1005
Fax Number
201-261-4208
person
Provider Business Mailing Address Details
Address
466 Old Hook Rd
City
Emerson
State
New Jersey
Zip
07630-1396
Phone Number
201-261-1005
Fax Number
201-261-4208
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
25MA0371400 (New Jersey)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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