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General NPI Number Information
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NPI Number | 1932706322
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL MEDICINE PRACTICE ASSOCIATES, PA
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 435 SOUTH STREET SUITE 160
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City | MORRISTOWN
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State | NJ
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Zip | 07960
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Country | US
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Telephone | 973-971-6301
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Fax | 973-290-7169
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Provider Business Mailing Address
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Address Line | 435 SOUTH STREET SUITE 160
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City | MORRISTOWN
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State | NJ
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Zip | 07960
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Country | US
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Telephone | 973-971-6301
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Fax | 973-290-7169
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | CHRISTOPHER P. ZIPP
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Credential | D.O.
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Telephone | 937-971-7257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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