Provider Demographics
NPI:1346379138
Name:MARY JANE WARDEN, MD, PA
Entity Type:Organization
Organization Name:MARY JANE WARDEN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:WARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-694-4155
Mailing Address - Street 1:2035 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6251
Mailing Address - Country:US
Mailing Address - Phone:973-694-4155
Mailing Address - Fax:973-694-6464
Practice Address - Street 1:2035 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6251
Practice Address - Country:US
Practice Address - Phone:973-694-4155
Practice Address - Fax:973-694-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty