Provider Demographics
NPI:1003123886
Name:ANA MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ANA MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADINA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ALEXESCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-241-8141
Mailing Address - Street 1:443 E WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-2428
Mailing Address - Country:US
Mailing Address - Phone:908-241-8141
Mailing Address - Fax:908-241-8186
Practice Address - Street 1:443 E WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-2428
Practice Address - Country:US
Practice Address - Phone:908-241-8141
Practice Address - Fax:908-241-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA6229126207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6670806Medicaid
NJ212579Medicare PIN
NMG20600Medicare UPIN