Provider Demographics
NPI:1710760749
Name:PATIENT FIRST NEW JERSEY PHYSICIANS GROUP LLC
Entity Type:Organization
Organization Name:PATIENT FIRST NEW JERSEY PHYSICIANS GROUP LLC
Other - Org Name:PATIENT FIRST - DELRAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-968-5700
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4000 ROUTE 130 BLDG C
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-2414
Practice Address - Country:US
Practice Address - Phone:856-705-0685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty