Provider Demographics
NPI:1457836363
Name:MEDICAL ASSOCIATES OF MENDHAM LLC
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES OF MENDHAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESTIFILIPPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-768-0338
Mailing Address - Street 1:22 INDIANHEAD RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4802
Mailing Address - Country:US
Mailing Address - Phone:973-768-0338
Mailing Address - Fax:
Practice Address - Street 1:5 COLD HILL RD S STE 9
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-3207
Practice Address - Country:US
Practice Address - Phone:973-768-0338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty