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General NPI Number Information
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NPI Number | 1720059934
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Entity Type | Organization
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Legal Business Name | WOODBRIDGE MEDICAL ASSOCIATES,P.A.
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 1000 ROUTE 9 N SUITE 302
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-1215
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Country | US
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Telephone | 732-634-0036
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Fax | 732-855-0112
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Provider Business Mailing Address
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Address Line | 1000 ROUTE 9 N SUITE 302
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-1215
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Country | US
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Telephone | 732-634-0036
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Fax | 732-855-0112
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY O'DONNELL
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Credential | M.D.
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Telephone | 732-634-0036
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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 | 207RN0300X
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Taxonomy Name | Nephrology 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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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