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NPI Code Detail

MEDICARE: MID ATLANTIC GERIATRIC ASSOCIATES-OCEAN, P.A

MEDICARE: MID ATLANTIC GERIATRIC ASSOCIATES-OCEAN, P.A
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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11134165210OTHERNPI

General Provider Information

NPI Number : 1134165210
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID ATLANTIC GERIATRIC ASSOCIATES-OCEAN, P.A
Provider Business Mailing Address
First Line : 1043 ROUTE 70
Second Line : UNIT C3
City : MANCHESTER
State : NJ
Zip : 08759-5806
Country : US
Telephone Number : 732-657-6100
Fax Number : 732-657-0111
Provider Business Practice Location Address
First Line : 1043 ROUTE 70
Second Line : UNIT C3
City : MANCHESTER
State : NJ
Zip : 08759-5806
Country : US
Telephone Number : 732-657-6100
Fax Number : 732-657-0111
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. JOSHUA R SHUA-HAIM
Credential : MD FACP AGSF CMD
Telephone Number : 732-657-6100
Provider Enumeration Date : 06/20/2006
Last Update Date : 03/18/2013

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Directions to “MID ATLANTIC GERIATRIC ASSOCIATES-OCEAN, P.A ” Practice Location

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