Provider Demographics
NPI:1760591341
Name:MEDICUS MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:MEDICUS MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKYAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1732-651-3133
Mailing Address - Street 1:561 CRANBURY RD
Mailing Address - Street 2:SUITE M
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:561 CRANBURY RD
Practice Address - Street 2:SUITE M
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5400
Practice Address - Country:US
Practice Address - Phone:173-265-1313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07436000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9003401Medicaid
NJ9003401Medicaid
NJ062978Medicare ID - Type Unspecified