MEDICARE: EAST ORANGE MEDICAL PRACTICE

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	207R00000X	Internal Medicine Physician	25MA08005400	NJ

General Provider Information

NPI Number	:	1114116175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST ORANGE MEDICAL PRACTICE

Provider Business Mailing Address
First Line	:	108 S MUNN AVE
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07018-3402
Country	:	US
Telephone Number	:	973-674-8100
Fax Number	:	973-674-8400

Provider Business Practice Location Address
First Line	:	108 S MUNN AVE
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07018-3402
Country	:	US
Telephone Number	:	973-674-8100
Fax Number	:	973-674-8400

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ROBERT A CLARKE
Credential	:	MD
Telephone Number	:	973-674-8100

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	10/16/2007

Similar Medicare Providers

1174798433 — ORANGE COUNTY NEWBORN MEDICARE CARE PC
Practice Location Address:

3 SAINT STEPHENS PL , SUITE 2
WARWICK, NY
10990-3208

Practice Phone: 845-987-9700
Practice Fax:

1851467294 — JAMES T CORT MD
Practice Location Address:

98 S MUNN AVE
EAST ORANGE, NJ
07018-3402

Practice Phone: 973-673-2260
Practice Fax: 973-673-5110

1558493577 — ESSEX ADULT, ADOLESCENT & PEDIATRIC MEDICAL, PC
Practice Location Address:

98 S MUNN AVE
EAST ORANGE, NJ
07018-3402

Practice Phone: 973-676-0500
Practice Fax: 973-676-0566

1528264462 — MRS. NATALIE Y ROBERTS-MOORE MS, RD
Practice Location Address:

108 S MUNN AVE
EAST ORANGE, NJ
07018-3402

Practice Phone: 973-674-8100
Practice Fax:

1700039435 — GLADZIM MEDICAL LABORATORIES INC.
Practice Location Address:

108 S MUNN AVE
EAST ORANGE, NJ
07018-3402

Practice Phone: 973-619-2622
Practice Fax: 973-677-1181

1770201121 — TRACY TAPPIN-GREENE
Practice Location Address:

108 S MUNN AVE
EAST ORANGE, NJ
07018-3402

Practice Phone: 973-674-8100
Practice Fax:

Directions to “EAST ORANGE MEDICAL PRACTICE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.