Healthcare Provider Details

I. General information

NPI: 1205509460
Provider Name (Legal Business Name): CORNERSTONE MEDICAL PROCEDURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2021
Last Update Date: 07/25/2021
Certification Date: 07/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 NEWARK POMPTON TPKE
RIVERDALE NJ
07457-1142
US

IV. Provider business mailing address

7 NEWARK POMPTON TPKE
RIVERDALE NJ
07457-1142
US

V. Phone/Fax

Practice location:
  • Phone: 973-831-1100
  • Fax:
Mailing address:
  • Phone: 973-831-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH YOUNG
Title or Position: OWNER
Credential: DC
Phone: 973-831-1100