Provider Demographics
NPI:1851506638
Name:ENDOCRINE ASSOCIATES OF RARITAN BAY, LLC
Entity Type:Organization
Organization Name:ENDOCRINE ASSOCIATES OF RARITAN BAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPILER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-360-1122
Mailing Address - Street 1:3 HOSPITAL PLZ
Mailing Address - Street 2:SUITE 307
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3093
Mailing Address - Country:US
Mailing Address - Phone:732-360-1122
Mailing Address - Fax:732-360-2725
Practice Address - Street 1:3 HOSPITAL PLZ
Practice Address - Street 2:SUITE 307
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3093
Practice Address - Country:US
Practice Address - Phone:732-360-1122
Practice Address - Fax:732-360-2725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA028129207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
092440Medicare PIN