Healthcare Provider Details
I. General information
NPI: 1780422014
Provider Name (Legal Business Name): BARNABAS HEALTH MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2024
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
766 ROUTE 202/206
BRIDGEWATER NJ
08807-1777
US
IV. Provider business mailing address
379 CAMPUS DR FL 4
SOMERSET NJ
08873-1161
US
V. Phone/Fax
- Phone: 908-722-0808
- Fax:
- Phone: 888-724-7123
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0010X |
| Taxonomy | Sports Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081S0010X |
| Taxonomy | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RURIC
ANDERSON
Title or Position: MD
Credential: MD
Phone: 848-336-1789