Healthcare Provider Details

I. General information

NPI: 1881891307
Provider Name (Legal Business Name): CENTRAL PHYSICIAN SERVICES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CENTRAL AVE
EAST ORANGE NJ
07018-2819
US

IV. Provider business mailing address

66 W GILBERT ST 2ND FLOOR
TINTON FALLS NJ
07701-4947
US

V. Phone/Fax

Practice location:
  • Phone: 973-672-8400
  • Fax:
Mailing address:
  • Phone: 732-212-0051
  • Fax: 732-212-0052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. DUANE J DYSON
Title or Position: PRESIDENT
Credential: MD
Phone: 732-212-0051