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NPI Code Detail

MEDICARE: PENNINGTON MEDICAL GROUP, PC

MEDICARE: PENNINGTON MEDICAL GROUP, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1922177070
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENNINGTON MEDICAL GROUP, PC
Provider Business Mailing Address
First Line : 820 BEAR TAVERN RD
Second Line : SUITE 102
City : EWING
State : NJ
Zip : 08628-1021
Country : US
Telephone Number : 607-737-7424
Fax Number : 609-882-5224
Provider Business Practice Location Address
First Line : 820 BEAR TAVERN RD
Second Line : SUITE 102
City : EWING
State : NJ
Zip : 08628-1021
Country : US
Telephone Number : 607-737-7424
Fax Number : 609-882-5224
Authorized Official
Title or Position : OWNER
Name : NIGAHUS KARABULUT
Credential : M.D.
Telephone Number : 609-737-7424
Provider Enumeration Date : 11/06/2006
Last Update Date : 04/20/2008

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