Provider Demographics
NPI:1659334449
Name:NEW JERSEY PHYSICIANS LLC
Entity Type:Organization
Organization Name:NEW JERSEY PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-777-7911
Mailing Address - Street 1:6 BRIGHTON RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1647
Mailing Address - Country:US
Mailing Address - Phone:973-777-7911
Mailing Address - Fax:973-594-1708
Practice Address - Street 1:6 BRIGHTON RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1647
Practice Address - Country:US
Practice Address - Phone:973-777-7911
Practice Address - Fax:973-594-1708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA72214207R00000X
NJ46414207R00000X
NJ25184207R00000X
NJMA70688207R00000X
NJ35259207R00000X
NJ34628207R00000X
NJMA067201207R00000X
NJ53182207RC0000X
NJMA35903207RG0100X
NJ59089207RG0100X
NJ61981207RP1001X
NJ27883207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH15410Medicare UPIN
NJC53183Medicare UPIN
NJC57773Medicare UPIN
NJD96967Medicare UPIN
NJG25638Medicare UPIN
NJB15191Medicare UPIN
NJC52570Medicare UPIN
NJD19447Medicare UPIN
NJD97052Medicare UPIN
NJC53823Medicare UPIN
NJC58324Medicare UPIN
NJH39641Medicare UPIN
NJF35041Medicare UPIN
NJG76169Medicare UPIN