Provider Demographics
NPI:1114145935
Name:CENTRAL JERSEY ENDOCRINE ASSOC LLC
Entity Type:Organization
Organization Name:CENTRAL JERSEY ENDOCRINE ASSOC LLC
Other - Org Name:RICHARD J AGRIN,MD, LEON SHULMAN,MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LEON
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-231-1311
Mailing Address - Street 1:720 US HIGHWAY 202/206 STE 1B
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1746
Mailing Address - Country:US
Mailing Address - Phone:908-385-1946
Mailing Address - Fax:908-231-1324
Practice Address - Street 1:720 US HIGHWAY 202/206 STE 1B
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1746
Practice Address - Country:US
Practice Address - Phone:908-385-1946
Practice Address - Fax:908-231-1321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ55313,56079,33417207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ529320OtherAETNA
NJ8695105Medicaid
NJ095518Medicare PIN