Healthcare Provider Details

I. General information

NPI: 1265141444
Provider Name (Legal Business Name): TRI AMERICA MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 LEMOINE AVE UNIT 1H
FORT LEE NJ
07024-6030
US

IV. Provider business mailing address

2185 LEMOINE AVE UNIT 1H
FORT LEE NJ
07024-6030
US

V. Phone/Fax

Practice location:
  • Phone: 844-755-8102
  • Fax:
Mailing address:
  • Phone: 844-755-8102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN STERN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 844-755-8102