Provider Demographics
NPI:1932369378
Name:MOUNTAIN VIEW FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MARION
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-764-5666
Mailing Address - Street 1:426 ROUTE 515
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07462-3027
Mailing Address - Country:US
Mailing Address - Phone:973-764-5666
Mailing Address - Fax:973-764-5778
Practice Address - Street 1:426 ROUTE 515
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462-3027
Practice Address - Country:US
Practice Address - Phone:973-764-5666
Practice Address - Fax:973-764-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00452700111N00000X
NJMB073164207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5603A1OtherWELL CHOICE
5996410OtherGHI
P2666266OtherOXFORD
3704975OtherAETNA
1846484OtherUNITED HEALTHCARE
5598108OtherFIRST HEALTH
7004396OtherCIGNA
5603A1OtherWELL CHOICE