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General NPI Number Information
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NPI Number | 1427016385
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Entity Type | Organization
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Legal Business Name | PRACTICE ASSOCIATES MEDICAL GROUP
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 100 MADISON AVENUE INTEROFFICE #68
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City | MORRISTOWN
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State | NJ
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Zip | 07960
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Country | US
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Telephone | 844-264-2250
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Fax | 973-290-8349
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Provider Business Mailing Address
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Address Line | PO BOX 416457
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City | BOSTON
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State | MA
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Zip | 02241-6457
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Country | US
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Telephone | 844-362-1735
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Fax | 973-290-8349
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | CHRISTOPHER ALOYCE HERZOG
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Credential |
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Telephone | 973-829-4320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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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 | 207P00000X
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Taxonomy Name | Emergency 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 | 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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Taxonomy #4
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery 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 | 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 #6
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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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 #8
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #15
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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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