Healthcare Provider Details

I. General information

NPI: 1376592683
Provider Name (Legal Business Name): MERIDIAN MEDICAL ASSOCIATES P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 STATE ROUTE 33
NEPTUNE NJ
07753-6110
US

IV. Provider business mailing address

2240 STATE ROUTE 33
NEPTUNE NJ
07753-6110
US

V. Phone/Fax

Practice location:
  • Phone: 732-897-3990
  • Fax: 732-897-3997
Mailing address:
  • Phone: 732-897-3990
  • Fax: 732-897-3997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: CARL MARCHETTI
Title or Position: DIRECTOR
Credential: M.D.
Phone: 732-775-8789