Provider Demographics
NPI:1942506076
Name:MEDICAL CENTERS OF NORTHERN NEW JERSEY
Entity Type:Organization
Organization Name:MEDICAL CENTERS OF NORTHERN NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-953-8105
Mailing Address - Street 1:195 S MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-5142
Mailing Address - Country:US
Mailing Address - Phone:973-953-8105
Mailing Address - Fax:
Practice Address - Street 1:195 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-5142
Practice Address - Country:US
Practice Address - Phone:973-953-8105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL CENTERS OF NORTHERN NEW JERSEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty