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General NPI Number Information
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NPI Number | 1770729212
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Entity Type | Organization
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Legal Business Name | HOSPITAL BASED PHYSICIANSASSOCIATES
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 97 W PARKWAY
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1647
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Country | US
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Telephone | 973-831-5454
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Fax | 973-831-5342
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Provider Business Mailing Address
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Address Line | PO BOX 726
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City | MAYS LANDING
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State | NJ
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Zip | 08330-0726
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Country | US
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Telephone | 609-625-3145
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Fax | 609-625-3145
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Authorized Official
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Title or Position | OFFICE BILLING MANAGER
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Name | MS. GIZZETTE MONIQUE GUZMAN
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Credential |
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Telephone | 609-625-3145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | MA59687
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License Number State | NJ
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