Healthcare Provider Details

I. General information

NPI: 1770749145
Provider Name (Legal Business Name): ERICKSON HEALTH MEDICAL GROUP OF NEW JERSEY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2008
Last Update Date: 10/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CEDAR CREST VILLAGE DR
POMPTON PLAINS NJ
07444-2100
US

IV. Provider business mailing address

5525 RESEARCH PARK DR FL 4
BALTIMORE MD
21228-4873
US

V. Phone/Fax

Practice location:
  • Phone: 973-831-3540
  • Fax: 973-831-3503
Mailing address:
  • Phone: 973-831-3540
  • Fax: 973-831-3503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW NARRETT
Title or Position: EXECUTIVE VP/CHIEF MEDICAL OFFICER
Credential: MD
Phone: 410-402-2261