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WOODBRIDGE MEDICAL GROUP P.A NPI 1881644011


NPI Information

NPI: 1881644011
Provider Name: WOODBRIDGE MEDICAL GROUP, P.A

Doing Business As: MAIN STREET PHYSICAL THERAPY

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 31D0107916

Address:
270 MAIN ST
WOODBRIDGE, NJ
ZIP 07095
Phone: (732) 636-5252
Get Directions

WOODBRIDGE MEDICAL GROUP, P.A is a family medicine in Woodbridge, NJ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WOODBRIDGE MEDICAL GROUP, P.A NPI is 1881644011. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Main Street Physical Therapy.

The provider's business location address is:

270 MAIN ST
WOODBRIDGE, NJ
ZIP 07095-927
Phone: (732) 636-5252
Fax: (732) 636-5452

The provider's authorized official is Robert D Boyd .
The authorized official title is President and has the following contact phone number (732) 636-5252.

The CLIA number assigned to this NPI record is 31D0107916 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2006 and was last updated on 11/8/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineMB30335NEW JERSEYYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C54818MEDICARE UPINNEW JERSEY
2517215MEDICARE PINNEW 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: 11/14/2023

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