Healthcare Provider Details

I. General information

NPI: 1760601033
Provider Name (Legal Business Name): MORRISTOWN PEDIATRIC ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 JAMES ST SUITE 1G
MORRISTOWN NJ
07960-6392
US

IV. Provider business mailing address

261 JAMES ST SUITE 1G
MORRISTOWN NJ
07960-6392
US

V. Phone/Fax

Practice location:
  • Phone: 973-540-9393
  • Fax: 973-540-1937
Mailing address:
  • Phone: 973-540-9393
  • Fax: 973-540-1937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. MARTIN LEWIS COHEN
Title or Position: PARTNER
Credential: MD
Phone: 73-540-9393