Healthcare Provider Details

I. General information

NPI: 1366501462
Provider Name (Legal Business Name): MONTGOMERY MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 12/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 DUTCHTOWN HARLINGEN RD
BELLE MEAD NJ
08502-5115
US

IV. Provider business mailing address

9 DUTCHTOWN HARLINGEN RD
BELLE MEAD NJ
08502-5115
US

V. Phone/Fax

Practice location:
  • Phone: 908-874-8883
  • Fax: 908-874-3595
Mailing address:
  • Phone: 908-874-8883
  • Fax: 908-874-3595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMB070954
License Number StateNJ

VIII. Authorized Official

Name: DR. JOSEPH J PECORA III
Title or Position: PRESIDENT
Credential: DO
Phone: 908-874-8883