Provider Demographics
NPI:1578508248
Name:JAMES A BOOZAN M D
Entity Type:Organization
Organization Name:JAMES A BOOZAN M D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALOYSIUS
Authorized Official - Last Name:BOOZAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-844-9661
Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BUILDING 5 SUITE 100
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2201
Mailing Address - Country:US
Mailing Address - Phone:609-844-9661
Mailing Address - Fax:609-844-9664
Practice Address - Street 1:3131 PRINCETON PIKE
Practice Address - Street 2:BUILDING 5 SUITE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2201
Practice Address - Country:US
Practice Address - Phone:609-844-9661
Practice Address - Fax:609-844-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6011501Medicaid
NJ6011501Medicaid
NJ744408Medicare PIN