Provider Demographics
NPI:1164743993
Name:TR MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:TR MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TAREK
Authorized Official - Middle Name:
Authorized Official - Last Name:REFAIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:551-208-0331
Mailing Address - Street 1:504 HAMBURG TPKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2034
Mailing Address - Country:US
Mailing Address - Phone:973-956-1459
Mailing Address - Fax:973-956-1473
Practice Address - Street 1:504 HAMBURG TPKE
Practice Address - Street 2:SUITE 202
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2034
Practice Address - Country:US
Practice Address - Phone:973-956-1459
Practice Address - Fax:973-956-1473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08496800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty