Healthcare Provider Details
I. General information
NPI: 1265696389
Provider Name (Legal Business Name): NICHOLAS A JARMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/17/2008
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1043 W MAIN ST
FREEHOLD NJ
07728-2538
US
IV. Provider business mailing address
1043 W MAIN ST
FREEHOLD NJ
07728-2538
US
V. Phone/Fax
- Phone: 732-800-9000
- Fax: 732-840-2088
- Phone: 732-800-9000
- Fax: 732-840-2088
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 25MA09107900 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XX0005X |
| Taxonomy | Sports Medicine (Orthopaedic Surgery) Physician |
| License Number | 25MA09107900 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: