Healthcare Provider Details

I. General information

NPI: 1184762478
Provider Name (Legal Business Name): ASSOCIATES IN INTERNAL MEDICINE-GARWOOD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 CENTER ST
GARWOOD NJ
07027-1231
US

IV. Provider business mailing address

91 CENTER ST
GARWOOD NJ
07027-1231
US

V. Phone/Fax

Practice location:
  • Phone: 908-789-0628
  • Fax: 908-789-2123
Mailing address:
  • Phone: 908-789-0628
  • Fax: 908-789-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB05872500
License Number StateNJ

VIII. Authorized Official

Name: JOHN M YAVORSKY
Title or Position: OWNER
Credential: DO
Phone: 908-789-0628