Provider Demographics
NPI:1609206671
Name:VANGUARD NORTH HALEDON AND OAKLAND PA
Entity Type:Organization
Organization Name:VANGUARD NORTH HALEDON AND OAKLAND PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCCARRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-239-2600
Mailing Address - Street 1:271 GROVE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1731
Mailing Address - Country:US
Mailing Address - Phone:973-559-3700
Mailing Address - Fax:973-559-8650
Practice Address - Street 1:271 GROVE AVE STE A
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1731
Practice Address - Country:US
Practice Address - Phone:973-239-2600
Practice Address - Fax:973-857-3503
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VANGUARD MEDICAL GROUP, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-12
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04268300207Q00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty