Provider Demographics
NPI:1952465569
Name:ALLIANCE MEDICAL GROUP, P.C.
Entity Type:Organization
Organization Name:ALLIANCE MEDICAL GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINEET
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-852-1887
Mailing Address - Street 1:137 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2307
Mailing Address - Country:US
Mailing Address - Phone:908-852-1887
Mailing Address - Fax:908-852-0614
Practice Address - Street 1:137 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2307
Practice Address - Country:US
Practice Address - Phone:908-852-1887
Practice Address - Fax:908-852-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6672906Medicaid
707179Medicare PIN