MEDICARE: MIDDLESEX MEDICAL CARE PC

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	207R00000X	Internal Medicine Physician	MA061062	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	41191	OTHER	NJ	AETNA GROUP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912986761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDDLESEX MEDICAL CARE PC

Provider Business Mailing Address
First Line	:	619 UNION AVE
Second Line	:	BUILDING 1 FIRST FLOOR
City	:	MIDDLESEX
State	:	NJ
Zip	:	08846-1963
Country	:	US
Telephone Number	:	732-356-3212
Fax Number	:	732-356-5002

Provider Business Practice Location Address
First Line	:	619 UNION AVE
Second Line	:	BUILDING 1 FIRST FLOOR
City	:	MIDDLESEX
State	:	NJ
Zip	:	08846-1963
Country	:	US
Telephone Number	:	732-356-3212
Fax Number	:	732-356-5002

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. LORI A. CARSGO
Credential	:
Telephone Number	:	732-356-3212

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	12/08/2009

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Directions to “MIDDLESEX MEDICAL CARE PC ” Practice Location

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