Healthcare Provider Details

I. General information

NPI: 1992463384
Provider Name (Legal Business Name): MVP MEDICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 12/02/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WYCKOFF ROAD
EATONTOWN NJ
07724
US

IV. Provider business mailing address

1803 HIGHWAY 35
OAKHURST NJ
07755-2974
US

V. Phone/Fax

Practice location:
  • Phone: 732-531-0100
  • Fax:
Mailing address:
  • Phone: 732-531-0100
  • Fax: 732-531-0144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROSE MICHELLE MOJARES
Title or Position: OWNER
Credential: PA-C
Phone: 732-531-4747