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General NPI Number Information
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NPI Number | 1316213184
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Entity Type | Organization
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Legal Business Name | EXECUTIVE HEALTH MEDICAL GROUP OF NEW JERSEY, PC
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 44 WHIPPANY RD
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City | MORRISTOWN
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State | NJ
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Zip | 07960-4558
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Country | US
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Telephone | 973-540-0177
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Fax |
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Provider Business Mailing Address
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Address Line | 10 ROCKEFELLER PLZ
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City | NEW YORK
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State | NY
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Zip | 10020-1903
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Country | US
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Telephone | 212-332-3700
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF ACCOUNTING
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Name | MS. ROXANA GUZMAN
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Credential |
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Telephone | 212-332-3725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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