=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053769604
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARILYN MCARTHUR MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2016
-----------------------------------------------------
Last Update Date | 05/24/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22 OLD SHORT HILLS RD SUITE 202
-----------------------------------------------------
City | LIVINGSTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07039-5604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-758-9311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 22 OLD SHORT HILLS RD SUITE 202
-----------------------------------------------------
City | LIVINGSTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07039-5604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-758-9311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. MARILYN MCARTHUR
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 973-758-9311
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 25MA03801600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------