# CARE STATION MEDICAL GROUP, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Care Station Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194045914
- **Authorized official:** MIRANDA J AGOSTO (BILLING MANAGER)
- **Authorized official phone:** (908) 925-7519

## Contact information

- **Practice address:** 456 PROSPECT AVE, WEST ORANGE, NJ 07052-4112
- **Practice address phone:** (973) 731-6767
- **Practice address fax:** (973) 731-9881
- **Mailing address:** PO BOX 352, LINDEN, NJ 07036-0352
- **Mailing address phone:** (908) 925-7519
- **Mailing address fax:** (908) 925-2842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/03/2010
- **Last updated:** 03/30/2017