Provider Demographics
NPI:1841290194
Name:TAYLOR, JEFF THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:THOMAS
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 COURTYARD DR
Mailing Address - Street 2:SUITE 213
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4247
Mailing Address - Country:US
Mailing Address - Phone:908-725-5200
Mailing Address - Fax:908-725-5223
Practice Address - Street 1:200 COURTYARD DRIVE
Practice Address - Street 2:SUITE 213
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4247
Practice Address - Country:US
Practice Address - Phone:908-725-5200
Practice Address - Fax:908-725-5223
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA70487207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8342407Medicaid
NJ036281Medicare ID - Type Unspecified
NJH12167Medicare UPIN