Healthcare Provider Details

I. General information

NPI: 1528108768
Provider Name (Legal Business Name): MEDICAL ASSOCIATES OF WESTFIELD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 SOUTH AVE E
WESTFIELD NJ
07090-1459
US

IV. Provider business mailing address

324 SOUTH AVE E
WESTFIELD NJ
07090-1459
US

V. Phone/Fax

Practice location:
  • Phone: 908-233-1444
  • Fax: 908-654-0226
Mailing address:
  • Phone: 908-233-1444
  • Fax: 908-654-0226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA04895200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA05100000
License Number StateNJ

VIII. Authorized Official

Name: DR. PETER JOHN WEIGEL
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 908-233-1444