Provider Demographics
NPI:1922048446
Name:MOUNTAINTOP MEDICAL LLC
Entity Type:Organization
Organization Name:MOUNTAINTOP MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMAR
Authorized Official - Middle Name:AMADOR
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-764-9392
Mailing Address - Street 1:859 NEWMANS LN
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08836-2139
Mailing Address - Country:US
Mailing Address - Phone:732-764-9392
Mailing Address - Fax:732-764-9392
Practice Address - Street 1:775 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-6262
Practice Address - Country:US
Practice Address - Phone:732-764-9392
Practice Address - Fax:732-764-9392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25 MA07428100207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF31122Medicare UPIN