Provider Demographics
NPI:1154382760
Name:MUNERA, RODOLFO A (MD)
Entity type:Individual
Prefix:DR
First Name:RODOLFO
Middle Name:A
Last Name:MUNERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7806
Mailing Address - Country:US
Mailing Address - Phone:973-472-8000
Mailing Address - Fax:
Practice Address - Street 1:1001 CLIFTON AVE STE 1B
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3586
Practice Address - Country:US
Practice Address - Phone:973-472-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA060136207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6875203Medicaid
NJ507704Medicare ID - Type Unspecified
NJ6875203Medicaid