Healthcare Provider Details

I. General information

NPI: 1861759490
Provider Name (Legal Business Name): JASON C GEORGE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 TREMONT AVE DEPARTMENT OF PULMONARY AND CRITICAL CARE MEDICINE
EAST ORANGE NJ
07018
US

IV. Provider business mailing address

385 TREMONT AVE DEPARTMENT OF PULMONARY AND CRITICAL CARE MEDICINE
EAST ORANGE NJ
07018
US

V. Phone/Fax

Practice location:
  • Phone: 973-676-1000
  • Fax: 973-395-7034
Mailing address:
  • Phone: 973-676-1000
  • Fax: 973-395-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA10354600
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MA10354600
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MA10354600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: