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General NPI Number Information
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NPI Number | 1962427484
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Entity Type | Organization
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Legal Business Name | CENTRAL JERSEY INTERNAL MEDICINE ASSOCIATES,PA
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 11/12/2012
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Provider Practice Location Address
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Address Line | 75 VERONICA AVE SUITE 204
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City | SOMERSET
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State | NJ
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Zip | 08873-5002
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Country | US
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Telephone | 732-828-0002
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Fax | 732-828-7070
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Provider Business Mailing Address
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Address Line | 75 VERONICA AVE SUITE 204
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City | SOMERSET
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State | NJ
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Zip | 08873-5002
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Country | US
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Telephone | 732-828-0002
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Fax | 732-828-7070
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | DR. DEEPAK K JAIN
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Credential | MD
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Telephone | 732-828-0002
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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 | NJ
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