MEDICARE: MEDASSIST NJ

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1215710298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDASSIST NJ

Provider Business Mailing Address
First Line	:	419 E COUNTY LINE RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1426
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	419 E COUNTY LINE RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1426
Country	:	US
Telephone Number	:	845-377-6670
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	YEHUDA SCHNEIDER
Credential	:
Telephone Number	:	917-968-3599

Provider Enumeration Date	:	08/15/2023
Last Update Date	:	08/15/2023

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Directions to “MEDASSIST NJ ” Practice Location

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