Healthcare Provider Details

I. General information

NPI: 1912082660
Provider Name (Legal Business Name): WILLIAM J MCHUGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 WILLIAMSON ST SUITE 204
ELIZABETH NJ
07202
US

IV. Provider business mailing address

240 WILLIAMSON ST SUITE 204
ELIZABETH NJ
07202
US

V. Phone/Fax

Practice location:
  • Phone: 908-355-8877
  • Fax: 908-355-0017
Mailing address:
  • Phone: 908-355-8877
  • Fax: 908-355-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA02430800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: