Provider Demographics
NPI:1003051038
Name:NAVESINK MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:NAVESINK MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FOLARIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:TUBOKU-METZGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-509-5012
Mailing Address - Street 1:PO BOX 4172
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-4172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:180 KINGS HWY
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2022
Practice Address - Country:US
Practice Address - Phone:732-671-0557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty