Provider Demographics
NPI:1669453817
Name:NORTH JERSEY MEDICAL PRACTICE ASSOCIATES PC
Entity type:Organization
Organization Name:NORTH JERSEY MEDICAL PRACTICE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUNZER
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARNOUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-942-5224
Mailing Address - Street 1:502 HAMBURG TPK
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470
Mailing Address - Country:US
Mailing Address - Phone:973-942-5224
Mailing Address - Fax:973-942-7443
Practice Address - Street 1:502 HAMBURG TPK
Practice Address - Street 2:SUITE 108
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-942-5224
Practice Address - Fax:973-942-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05795100207RG0100X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8796904Medicaid
048005Medicare ID - Type Unspecified