# NORTHERN MECIAL CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386675718
- **Authorized official:** MIRA MATCHIN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (732) 238-3800

## Contact information

- **Practice address:** 51 W PROSPECT ST, EAST BRUNSWICK, NJ 08816-5711
- **Practice address phone:** (732) 238-3800
- **Practice address fax:** (732) 238-2883
- **Mailing address:** 51 W PROSPECT ST, EAST BRUNSWICK, NJ 08816-5711
- **Mailing address phone:** (732) 238-3800
- **Mailing address fax:** (732) 238-2883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | MA 039611 | NJ | — |
| 207R00000X | Internal Medicine Physician | 25MA07937500 | NJ | — |
| 207R00000X | Internal Medicine Physician | 25MB07663700 | NJ | Yes |
| 213E00000X | Podiatrist | 25MD00274100 | NJ | — |

## Other

- **Enumeration date:** 07/05/2006
- **Last updated:** 09/11/2025