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General NPI Number Information
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NPI Number | 1083112122
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Entity Type | Organization
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Legal Business Name | KMG MEDICAL GROUP NJ, P.A.
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 101 EISENHOWER PKWY
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City | ROSELAND
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State | NJ
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Zip | 07068-1032
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Country | US
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Telephone | 833-745-3377
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Fax | 646-224-8614
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Provider Business Mailing Address
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Address Line | 27 E 28TH ST FL 12
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City | NEW YORK
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State | NY
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Zip | 10016-7921
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Country | US
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Telephone | 361-563-5508
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Fax | 646-224-8614
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MICHAEL D KARAGAS
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Credential | MD
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Telephone | 361-563-5508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA10245700
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License Number State | NJ
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