Provider Demographics
NPI:1821630286
Name:FRESH START MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:FRESH START MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SPEESLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-249-6300
Mailing Address - Street 1:7 KATHY ST
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1629
Mailing Address - Country:US
Mailing Address - Phone:732-310-7274
Mailing Address - Fax:732-960-2301
Practice Address - Street 1:317 CLEVELAND AVE FL 1
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1817
Practice Address - Country:US
Practice Address - Phone:732-249-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain