Provider Demographics
NPI:1770651382
Name:MEDICAL ASSOCIATES OF NEW BRUNSWICK, P.A.
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES OF NEW BRUNSWICK, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURO
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-254-2216
Mailing Address - Street 1:8 AUER CT
Mailing Address - Street 2:SUITES C & D
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5846
Mailing Address - Country:US
Mailing Address - Phone:732-254-2216
Mailing Address - Fax:732-254-1027
Practice Address - Street 1:8 AUER CT
Practice Address - Street 2:SUITES C & D
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5846
Practice Address - Country:US
Practice Address - Phone:732-254-2216
Practice Address - Fax:732-254-1027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA51880207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD06835Medicare UPIN