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General NPI Number Information
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NPI Number | 1508072745
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Entity Type | Organization
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Legal Business Name | REFORMED CHURCH MINISTRIES TO THE AGING, THE PARTICULAR SYNOD OF THE M
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 1990 STATE ROUTE 18
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-3771
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Country | US
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Telephone | 732-607-9230
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Fax | 732-607-9231
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Provider Business Mailing Address
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Address Line | PO BOX 1247
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City | TOMS RIVER
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State | NJ
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Zip | 08754-1247
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | EDWARD MEZIC
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Credential | MD
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Telephone | 732-349-3838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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