Provider Demographics
NPI:1578792040
Name:HAMPTON FAMILY PRACTICE, LLC
Entity Type:Organization
Organization Name:HAMPTON FAMILY PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:P
Authorized Official - Last Name:MADURA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:908-537-1042
Mailing Address - Street 1:450 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08827-2535
Mailing Address - Country:US
Mailing Address - Phone:908-537-1042
Mailing Address - Fax:908-537-1043
Practice Address - Street 1:450 CHARLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08827-2535
Practice Address - Country:US
Practice Address - Phone:908-537-1042
Practice Address - Fax:908-537-1043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03922600261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care