Healthcare Provider Details

I. General information

NPI: 1811789753
Provider Name (Legal Business Name): TEAMMD AT MILLBURN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 E WILLOW ST
MILLBURN NJ
07041-1416
US

IV. Provider business mailing address

14 CLIFFWOOD AVE
MATAWAN NJ
07747-3908
US

V. Phone/Fax

Practice location:
  • Phone: 973-821-3387
  • Fax:
Mailing address:
  • Phone: 973-912-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. NICK BUFANO
Title or Position: MANAGING PARTNER
Credential:
Phone: 973-912-8111