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General NPI Number Information
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NPI Number | 1336203538
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Entity Type | Organization
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Legal Business Name | HACKENSACK MERIDIAN HEALTH MEDICAL GROUP - PRIMARY CARE PC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 331 NEWMAN SPRINGS RD STE 220
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City | RED BANK
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State | NJ
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Zip | 07701-5688
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Country | US
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Telephone | 732-807-0800
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Fax | 327-922-0548
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Provider Business Mailing Address
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Address Line | PO BOX 95000-7730
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City | PHILADELPHIA
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State | PA
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Zip | 19195-0001
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Country | US
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Telephone | 732-807-0800
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Fax | 327-922-0527
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Authorized Official
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Title or Position | DIRECTOR
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Name | DANIEL VARGA
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Credential | M.D.
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Telephone | 732-807-0800
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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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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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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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