Healthcare Provider Details

I. General information

NPI: 1629553946
Provider Name (Legal Business Name): INFOCUS MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CAMPUS TOWN CIR STE 100
EWING NJ
08638-1962
US

IV. Provider business mailing address

100 CAMPUS TOWN CIR STE 100
EWING NJ
08638-1962
US

V. Phone/Fax

Practice location:
  • Phone: 609-799-7009
  • Fax:
Mailing address:
  • Phone: 856-625-6343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT PERRINE
Title or Position: DIRECTOR OF CORPORATE DEVELOPMENT
Credential:
Phone: 609-994-7090