Gonzalez Mejia, Johanna Jacqueline

Gonzalez Mejia, Johanna Jacqueline is an sole proprietor health care provider with primary practice located at 433 North Broad Street , Elizabeth NJ 07208-3398. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Gonzalez Mejia, Johanna Jacqueline can be contacted via phone (908) 436-1002.

Contact Information

Primary practice address
433 North Broad Street Elizabeth NJ 07208-3398
Phone: (908) 436-1002
Fax: (908) 436-1109
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 25MA06899700 New Jersey

Profile Details

NPI number 1669565396
LBN Legal business name Gonzalez Mejia, Johanna Jacqueline
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669565396 NPPES
New Jersey Other 202092816 TAX ID,
New Jersey Other AH0236165301 TAX ID,
New Jersey Other 60013229 TAX ID,
New Jersey Other 01000296602 TAX ID,
New Jersey Other 97222 TAX ID,
New Jersey MEDICAID 8565708 TAX ID,
New Jersey Other 31002 TAX ID,
New Jersey Other 7752202 TAX ID,

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