Provider Demographics
NPI:1295749075
Name:ATLANTIC MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:ATLANTIC MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:WOLFMULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-988-6300
Mailing Address - Street 1:1200 EAGLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712
Mailing Address - Country:US
Mailing Address - Phone:732-988-6300
Mailing Address - Fax:732-988-4587
Practice Address - Street 1:1200 EAGLE AVENUE
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712
Practice Address - Country:US
Practice Address - Phone:732-988-6300
Practice Address - Fax:732-988-4587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty