Provider Demographics
NPI:1558664599
Name:ADY, JUSTIN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:WILLIAM
Last Name:ADY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:ONE ROBERT WOOD JOHNSON PLACE
Mailing Address - Street 2:MEDICAL EDUCATION BUILDING 541
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901
Mailing Address - Country:US
Mailing Address - Phone:735-235-7816
Mailing Address - Fax:
Practice Address - Street 1:ONE ROBERT WOOD JOHNSON PLACE
Practice Address - Street 2:MEDICAL EDUCATION BUILDING 541
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:732-235-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA101409002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery