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General NPI Number Information
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NPI Number | 1306781299
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Entity Type | Organization
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Legal Business Name | MOUNT FREEDOM MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 16 OLD BROOKSIDE RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-3617
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Country | US
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Telephone | 609-592-2293
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Fax | 347-719-3010
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Provider Business Mailing Address
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Address Line | 7 SKYLINE DR
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City | RANDOLPH
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State | NJ
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Zip | 07869-2156
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Country | US
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Telephone | 609-592-2293
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Fax | 347-719-3010
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Authorized Official
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Title or Position | MD
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Name | JASVENDAR SINGH NANDRA
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Credential |
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Telephone | 609-592-2293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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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 | 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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