Provider Demographics
NPI:1972653624
Name:MEDICAL ASSOCIATES OF CENTRAL JERSEY,PA
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES OF CENTRAL JERSEY,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIR
Authorized Official - Middle Name:SHARIF
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-422-8440
Mailing Address - Street 1:21 CLYDE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5043
Mailing Address - Country:US
Mailing Address - Phone:732-422-8440
Mailing Address - Fax:732-422-8404
Practice Address - Street 1:21 CLYDE RD STE 102
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5043
Practice Address - Country:US
Practice Address - Phone:732-422-8440
Practice Address - Fax:732-422-8404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA062819261QM2500X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG61676Medicare UPIN
NJ003706Medicare PIN