Healthcare Provider Details

I. General information

NPI: 1366047144
Provider Name (Legal Business Name): CPC MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 US HIGHWAY 202 NORTH
BRIDGEWATER NJ
08807-2550
US

IV. Provider business mailing address

793 US HIGHWAY 202 NORTH
BRIDGEWATER NJ
08807-2550
US

V. Phone/Fax

Practice location:
  • Phone: 201-685-0301
  • Fax:
Mailing address:
  • Phone: 201-685-0301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHANG GREGORY
Title or Position: PARTNER
Credential: MD
Phone: 732-266-3994