MEDICARE: MIDDLEBROOK FAMILY PHYSICIANS, PA

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1740323021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDDLEBROOK FAMILY PHYSICIANS, PA

Provider Business Mailing Address
First Line	:	101 E UNION AVE
Second Line	:
City	:	BOUND BROOK
State	:	NJ
Zip	:	08805-1713
Country	:	US
Telephone Number	:	732-560-0490
Fax Number	:	732-560-3681

Provider Business Practice Location Address
First Line	:	101 E UNION AVE
Second Line	:
City	:	BOUND BROOK
State	:	NJ
Zip	:	08805-1713
Country	:	US
Telephone Number	:	732-560-0490
Fax Number	:	732-560-3681

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	TERESA SODEN
Credential	:
Telephone Number	:	732-560-0490

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	04/09/2008

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