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General NPI Number Information
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NPI Number | 1942424783
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Entity Type | Organization
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Legal Business Name | CHANGEBRIDGE MEDICAL ASSOCIATES PA
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 170 CHANGEBRIDGE RD. SUITE C-3
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City | MONTVILLE
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State | NJ
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Zip | 07045-9112
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Country | US
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Telephone | 973-575-5540
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Fax | 973-575-4885
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Provider Business Mailing Address
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Address Line | 170 CHANGEBRIDGE RD SUITE C-3
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City | MONTVILLE
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State | NJ
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Zip | 07045-9112
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Country | US
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Telephone | 973-575-5540
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Fax | 975-575-4885
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ARNOLD PALLAY
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Credential | M.D
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Telephone | 973-575-5540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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