Healthcare Provider Details

I. General information

NPI: 1083096598
Provider Name (Legal Business Name): JUSTIN PI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 06/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 COLBY PL
MORGANVILLE NJ
07751-1744
US

IV. Provider business mailing address

241 COLBY PL
MORGANVILLE NJ
07751-1744
US

V. Phone/Fax

Practice location:
  • Phone: 732-856-0980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN PI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 732-856-0980