Provider Demographics
NPI:1346304664
Name:UNIVERSITY MEDICAL PROFESSIONALS LLC
Entity Type:Organization
Organization Name:UNIVERSITY MEDICAL PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIPIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-994-8880
Mailing Address - Street 1:240 WILLIAMSON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3674
Mailing Address - Country:US
Mailing Address - Phone:908-994-8880
Mailing Address - Fax:908-994-8882
Practice Address - Street 1:240 WILLIAMSON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3674
Practice Address - Country:US
Practice Address - Phone:908-994-8880
Practice Address - Fax:908-994-8882
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIPIN GARG
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-21
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA70132207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
NY220328207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0065323Medicaid
NJ0065323Medicaid