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General NPI Number Information
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NPI Number | 1205063633
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Entity Type | Organization
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Legal Business Name | SOMERSET MEDICAL GROUP
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Dates
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Enumeration Date | 06/11/2009
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 3322 RTE 22 SUITE806
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City | BRANCHBURG
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State | NJ
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Zip | 08876-3476
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Country | US
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Telephone | 908-448-1893
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Fax |
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Provider Business Mailing Address
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Address Line | 3322 RTE 22 STE 806
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City | BRANCHBURG
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State | NJ
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Zip | 08876-4406
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Country | US
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Telephone | 908-448-1893
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | VASANTHI KACHIRAYAN
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Credential |
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Telephone | 908-448-1893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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