Most Relevant Information
Provider Data
| NPI Number: | 1003323908 |
| Provider Name: | RAYMOND N. DIVIRGILIO |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 25MT00031600 |
Most Important Dates
| Enumeration Date: | 01/02/2018 |
| Last Updated: | 01/02/2018 |
Provider Practice Location
1000 MORRIS AVE
UNION
NJ
070837133
Practice Location Phone/Fax
| Phone: | 9087370663 |
| Fax: |
Provider Mailing Location
119 GLENWOOD RD
FANWOOD
NJ
070231474
Provider Mailing Phone/Fax
| Phone: | 9087370663 |
| Fax: |