Provider Demographics
NPI:1447599519
Name:MAXIM KARABACH, MD, LLC
Entity Type:Organization
Organization Name:MAXIM KARABACH, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTING PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MAXIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KARABACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-716-1700
Mailing Address - Street 1:67 - LACEY RD.
Mailing Address - Street 2:STE 5
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2354
Mailing Address - Country:US
Mailing Address - Phone:732-716-1700
Mailing Address - Fax:732-716-0500
Practice Address - Street 1:67 - LACEY RD.
Practice Address - Street 2:STE 5
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2354
Practice Address - Country:US
Practice Address - Phone:732-716-1700
Practice Address - Fax:732-716-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA66521207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty