Provider Demographics
NPI:1265474860
Name:MEDICAL ASSOCIATES OF NORTH JERSEY,P.A.
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES OF NORTH JERSEY,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRABSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-839-3333
Mailing Address - Street 1:525 WANAQUE AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-1843
Mailing Address - Country:US
Mailing Address - Phone:973-839-3333
Mailing Address - Fax:973-839-0580
Practice Address - Street 1:525 WANAQUE AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-1843
Practice Address - Country:US
Practice Address - Phone:973-839-3333
Practice Address - Fax:973-839-0580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO65228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty