Provider Demographics
NPI:1700442415
Name:METROPOLITAN MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:METROPOLITAN MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-672-2455
Mailing Address - Street 1:570 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-1904
Mailing Address - Country:US
Mailing Address - Phone:973-672-8573
Mailing Address - Fax:973-675-0040
Practice Address - Street 1:570 PARK AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1904
Practice Address - Country:US
Practice Address - Phone:973-672-8573
Practice Address - Fax:973-675-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty