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General NPI Number Information
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NPI Number | 1023348232
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Entity Type | Organization
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Legal Business Name | JOSEPH PORTER M.D. P.A.
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Dates
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Enumeration Date | 01/11/2010
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 50 MOUNT PROSPECT AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-1900
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Country | US
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Telephone | 973-574-9880
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Fax | 973-574-9819
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Provider Business Mailing Address
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Address Line | 50 MOUNT PROSPECT AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-1900
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Country | US
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Telephone | 973-574-9880
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Fax | 973-574-9819
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH PORTER
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Credential | M.D.
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Telephone | 973-574-9880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA46587
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License Number State | NJ
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