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General NPI Number Information
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NPI Number | 1225115066
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Entity Type | Organization
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Legal Business Name | MEDICAL ASSOCIATES OF FREEHOLD LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 1 APPLEWOOD DRIVE
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City | FREEHOLD
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State | NJ
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Zip | 07728-5309
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Country | US
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Telephone | 732-946-7249
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Fax | 732-946-2540
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Provider Business Mailing Address
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Address Line | 27 WILDHEDGE LN
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City | HOLMDEL
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State | NJ
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Zip | 07733-2115
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Country | US
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Telephone | 732-946-7249
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Fax | 732-946-2540
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES WESTON HAYNE
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Credential | DO
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Telephone | 732-462-1036
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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 |
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License Number State |
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