Healthcare Provider Details

I. General information

NPI: 1528250503
Provider Name (Legal Business Name): M&A MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 OLD HOOK RD
WESTWOOD NJ
07675-3123
US

IV. Provider business mailing address

645 WESTWOOD AVE
RIVERVALE NJ
07675-6295
US

V. Phone/Fax

Practice location:
  • Phone: 201-358-3444
  • Fax: 201-722-4514
Mailing address:
  • Phone: 201-358-6774
  • Fax: 201-358-1140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMA43438
License Number StateNJ

VIII. Authorized Official

Name: DR. MANUEL ALVAREZ
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 201-358-6774