Provider Demographics
NPI:1639116551
Name:THE DOCTOR'S OFFICE OF MIDDLESEX, P.C.
Entity Type:Organization
Organization Name:THE DOCTOR'S OFFICE OF MIDDLESEX, P.C.
Other - Org Name:MIDDLESEX DOCTOR'S OFFICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:I
Authorized Official - Last Name:BERKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-634-3069
Mailing Address - Street 1:1 WOODBRIDGE CTR
Mailing Address - Street 2:SUITE 900
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1150
Mailing Address - Country:US
Mailing Address - Phone:732-634-3069
Mailing Address - Fax:732-791-2159
Practice Address - Street 1:1 WOODBRIDGE CTR
Practice Address - Street 2:SUITE 900
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1150
Practice Address - Country:US
Practice Address - Phone:732-634-3069
Practice Address - Fax:732-791-2159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0084549Medicaid
NJ096864Medicare ID - Type Unspecified