Provider Demographics
NPI:1396850228
Name:AFFILIATED PHYSICIANS NETWORK, P.C.
Entity Type:Organization
Organization Name:AFFILIATED PHYSICIANS NETWORK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:PROBE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:856-845-0360
Mailing Address - Street 1:740 MANTUA PIKE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08097-1149
Mailing Address - Country:US
Mailing Address - Phone:856-845-0360
Mailing Address - Fax:856-845-1881
Practice Address - Street 1:740 MANTUA PIKE
Practice Address - Street 2:
Practice Address - City:WOODBURY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08097-1149
Practice Address - Country:US
Practice Address - Phone:856-845-0360
Practice Address - Fax:856-845-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00269500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6298508Medicaid
NJ0761309000OtherAMERIHEALTH/HMO-PPO-POS
NJ0761309000OtherBLUE CROSS OF PA/PPO
NJ621921OtherUNITED HEALTHCARE
NJ1071258OtherHORIZON NJ HEALTH
NJ0526304OtherAETNA
NJ0761309000OtherKEYSTONE
NJ0761309000OtherBLUE CROSS OF PA/PPO
NJ621921OtherUNITED HEALTHCARE
NJ0761309000OtherAMERIHEALTH/HMO-PPO-POS
NJ0761309000OtherBLUE CROSS OF PA/PPO