Provider Demographics
NPI:1871840173
Name:PALLIATIVE MEDICINE ASSOCIATES LLC
Entity Type:Organization
Organization Name:PALLIATIVE MEDICINE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CORRADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-283-8233
Mailing Address - Street 1:PO BOX 1002
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-5002
Mailing Address - Country:US
Mailing Address - Phone:973-512-3346
Mailing Address - Fax:973-512-3462
Practice Address - Street 1:55 NEWTON SPARTA RD
Practice Address - Street 2:SUITE 103
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2772
Practice Address - Country:US
Practice Address - Phone:973-512-3346
Practice Address - Fax:973-512-3462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA079823002081H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative MedicineGroup - Single Specialty