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General NPI Number Information
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NPI Number | 1568506152
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Entity Type | Organization
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Legal Business Name | KEARNY MEDICAL ASSOCIATES PC
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 728 KEARNY AVE
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City | KEARNY
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State | NJ
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Zip | 07032-3048
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Country | US
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Telephone | 201-955-0660
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Fax | 201-955-0663
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Provider Business Mailing Address
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Address Line | 728 KEARNY AVE
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City | KEARNY
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State | NJ
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Zip | 07032-3048
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Country | US
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Telephone | 201-955-0660
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Fax | 201-955-0663
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Authorized Official
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Title or Position | M.D
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Name | OLEG FRANK
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Credential |
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Telephone | 201-955-0660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA073494
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License Number State | NJ
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