MID JERSEY MEDICAL ASSOCIATES PA NPI 1184722431

NPI Information

NPI: 1184722431
Provider Name: MID JERSEY MEDICAL ASSOCIATES, PA
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 31D0942247

Address:
1 ETHEL RD
SUITE 107B
EDISON, NJ
ZIP 08817
Phone: (732) 287-2020
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MID JERSEY MEDICAL ASSOCIATES, PA is a primary care clinic center in Edison, NJ. MID JERSEY MEDICAL ASSOCIATES, PA NPI is 1184722431. The provider is registered as an organization entity type.

The provider's business location address is:

1 ETHEL RD
SUITE 107B
EDISON, NJ
ZIP 08817-838
Phone: (732) 287-2020

The provider's authorized official is Machia Uthappa .
The authorized official title is Owner and has the following contact phone number (732) 287-2020.

The CLIA number assigned to this NPI record is 31D0942247 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 9/29/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	MA061302	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7894406	MEDICAID	NEW JERSEY
2	G27904	MEDICARE UPIN
3	1124098678	OTHER		INDIVIDUAL NPI NUMBER
4	103233	MEDICARE ID-TYPE UNSPECIFIED	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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