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General NPI Number Information
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NPI Number | 1386275352
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Entity Type | Organization
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Legal Business Name | MGM MEDICAL CENTER
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Dates
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Enumeration Date | 01/29/2020
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 262 WILLIAM ST
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City | EAST ORANGE
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State | NJ
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Zip | 07017-4324
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Country | US
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Telephone | 973-677-2231
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Fax | 973-677-2231
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Provider Business Mailing Address
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Address Line | 262 WILLIAM ST
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City | EAST ORANGE
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State | NJ
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Zip | 07017-4324
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Country | US
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Telephone | 973-677-2233
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Fax | 973-677-2231
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MALEKA ROBINSON
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Credential | APRN-BC, MSN, RN
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Telephone | 973-677-2233
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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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