Healthcare Provider Details

I. General information

NPI: 1144614249
Provider Name (Legal Business Name): MICHAEL MCENTEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 BEAUVOIR AVE
SUMMIT NJ
07901-3533
US

IV. Provider business mailing address

16 NATHAN DR
NORTH BRUNSWICK NJ
08902-1226
US

V. Phone/Fax

Practice location:
  • Phone: 908-522-2000
  • Fax:
Mailing address:
  • Phone: 732-421-7353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MA10297200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: