MEDICARE: MONTGOMERY MEDICAL ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	25MB07095400	NJ

General Provider Information

NPI Number	:	1013455526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTGOMERY MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	9 DUTCHTOWN HARLINGEN RD
Second Line	:
City	:	BELLE MEAD
State	:	NJ
Zip	:	08502-5115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 DUTCHTOWN HARLINGEN RD
Second Line	:
City	:	BELLE MEAD
State	:	NJ
Zip	:	08502-5115
Country	:	US
Telephone Number	:	908-874-8883
Fax Number	:

Authorized Official
Title or Position	:	OWNER OPERATOR
Name	:	DR. JOSEPH PECORA
Credential	:	DO
Telephone Number	:	908-874-8883

Provider Enumeration Date	:	02/03/2017
Last Update Date	:	02/03/2017

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