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NPI Code Detail

MEDICARE: MEDICAL PRACTITIONERS OF NORTHERN NEW JERSEY INC

MEDICARE: MEDICAL PRACTITIONERS OF NORTHERN NEW JERSEY INC
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
1174400000XSpecialist

General Provider Information

NPI Number : 1720028194
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL PRACTITIONERS OF NORTHERN NEW JERSEY INC
Provider Business Mailing Address
First Line : PO BOX 623
Second Line :
City : POMPTON PLAINS
State : NJ
Zip : 07444-0623
Country : US
Telephone Number : 973-839-8444
Fax Number : 973-839-8445
Provider Business Practice Location Address
First Line : 444 MARKET ST
Second Line :
City : SADDLE BROOK
State : NJ
Zip : 07663-5996
Country : US
Telephone Number : 201-843-9441
Fax Number : 201-843-9442
Authorized Official
Title or Position : CEO
Name : ALFRED MAURO
Credential :
Telephone Number : 973-839-8444
Provider Enumeration Date : 06/07/2006
Last Update Date : 08/22/2020

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Directions to “MEDICAL PRACTITIONERS OF NORTHERN NEW JERSEY INC ” Practice Location

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