Healthcare Provider Details

I. General information

NPI: 1396749354
Provider Name (Legal Business Name): SOMERSET MEDICAL ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 07/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1553 HIGHWAY 27 3100
SOMERSET NJ
08873-3993
US

IV. Provider business mailing address

PO BOX 8500-3240
PHILADELPHIA PA
19178-0001
US

V. Phone/Fax

Practice location:
  • Phone: 732-846-3385
  • Fax: 732-846-0037
Mailing address:
  • Phone: 732-730-3615
  • Fax: 732-730-3619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: SUSAN A MCMANUS
Title or Position: OWNER
Credential: M.D.
Phone: 732-846-3385