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General NPI Number Information
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NPI Number | 1922048446
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Entity Type | Organization
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Legal Business Name | MOUNTAINTOP MEDICAL LLC
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 775 MOUNTAIN BLVD
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City | WATCHUNG
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State | NJ
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Zip | 07069-6262
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Country | US
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Telephone | 732-764-9392
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Fax | 732-764-9392
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Provider Business Mailing Address
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Address Line | 859 NEWMANS LN
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City | MARTINSVILLE
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State | NJ
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Zip | 08836-2139
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Country | US
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Telephone | 732-764-9392
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Fax | 732-764-9392
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. HOMAR AMADOR MARTINEZ
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Credential | MD
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Telephone | 732-764-9392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 25 MA07428100
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License Number State | NJ
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