DEWI S. SUDJONO-SANTOSO NPI 1124417639

NPI Information

  • NPI: 1124417639
  • Provider Name: DEWI S. SUDJONO-SANTOSO
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • Other Name: SAME AS ABOVE
  • Address: 339 PRINCETON-HIGHTSTOWN RD
    BUILDING B
    CRANBURY, NJ
    ZIP 08512
  • Phone: (609) 918-1030

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NPI Details

DEWI S. SUDJONO-SANTOSO is an adolescent medicine pediatrics in Cranbury, NJ. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DEWI S. SUDJONO-SANTOSO NPI is 1124417639. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Same As Above.

The provider's business location address is:

339 PRINCETON-HIGHTSTOWN RD
BUILDING B
CRANBURY, NJ
ZIP 08512
Phone: (609) 918-1030
Fax: (609) 918-1322

The provider's authorized official is Dewi S Sudjono-santoso .
The authorized official title is Owner and has the following contact phone number (609) 918-1030.

The enumeration date for this NPI number is 1/21/2015 and was last updated on 1/21/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent MedicineMA01513300NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11053342865MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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