Healthcare Provider Details

I. General information

NPI: 1659947091
Provider Name (Legal Business Name): SUMMIT MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 05/27/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 HOOPER AVE # 2
TOMS RIVER NJ
08753-8319
US

IV. Provider business mailing address

1 DIAMOND HILL RD
BERKELEY HEIGHTS NJ
07922-2104
US

V. Phone/Fax

Practice location:
  • Phone: 732-228-4146
  • Fax: 732-504-7104
Mailing address:
  • Phone: 908-273-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PETER T SAUNDERS
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 908-588-3930