Healthcare Provider Details

I. General information

NPI: 1669453817
Provider Name (Legal Business Name): NORTH JERSEY MEDICAL PRACTICE ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 07/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 HAMBURG TPK SUITE 108
WAYNE NJ
07470
US

IV. Provider business mailing address

502 HAMBURG TPK SUITE 108
WAYNE NJ
07470
US

V. Phone/Fax

Practice location:
  • Phone: 973-942-5224
  • Fax: 973-942-7443
Mailing address:
  • Phone: 973-942-5224
  • Fax: 973-942-7443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number25MA05795100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MUNZER M ARNOUK
Title or Position: PRESIDENT
Credential: MD
Phone: 973-942-5224