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NPI Code Detail

MEDICARE: DR. JOSEPH PORTER M.D.

MEDICARE: DR. JOSEPH PORTER M.D.
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
1207R00000XInternal Medicine PhysicianMA46587NJ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
211022326OTHERNJRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639264393
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH PORTER M.D.
Provider Business Mailing Address
First Line : 50 MOUNT PROSPECT AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07013-1900
Country : US
Telephone Number : 973-574-9880
Fax Number : 973-574-9819
Provider Business Practice Location Address
First Line : 50 MOUNT PROSPECT AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07013-1900
Country : US
Telephone Number : 973-574-9880
Fax Number : 973-574-9819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 01/11/2010

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Directions to “ DR. JOSEPH PORTER M.D.” Practice Location

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