Provider Demographics
NPI:1184762478
Name:ASSOCIATES IN INTERNAL MEDICINE-GARWOOD, LLC
Entity type:Organization
Organization Name:ASSOCIATES IN INTERNAL MEDICINE-GARWOOD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:YAVORSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:908-789-0628
Mailing Address - Street 1:91 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:GARWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07027-1231
Mailing Address - Country:US
Mailing Address - Phone:908-789-0628
Mailing Address - Fax:908-789-2123
Practice Address - Street 1:91 CENTER ST
Practice Address - Street 2:
Practice Address - City:GARWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07027-1231
Practice Address - Country:US
Practice Address - Phone:908-789-0628
Practice Address - Fax:908-789-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05872500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6825702Medicaid
NJP783147OtherOXFORD
NJ1K1554OtherHEALTHNET
NJ121254Medicare ID - Type Unspecified
NJP783147OtherOXFORD