Provider Demographics
NPI:1558377473
Name:NAGY, JASON J (PA-C)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:J
Last Name:NAGY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 OAK TREE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2070
Mailing Address - Country:US
Mailing Address - Phone:732-548-7332
Mailing Address - Fax:732-548-7350
Practice Address - Street 1:1907 OAK TREE RD STE 201
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2070
Practice Address - Country:US
Practice Address - Phone:732-548-7332
Practice Address - Fax:732-548-7350
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00142500363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ093581ACDMedicare ID - Type Unspecified
NJQ49667Medicare UPIN