# MOUNT PROSPECT MEDICAL GROUP,LLC

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

## Provider details

- **NPI number:** 1700245255
- **Authorized official:** MR. ALEXANDER G SALERNO M.D. (OWNER/PRESIDENT)
- **Authorized official phone:** (973) 672-2455

## Contact information

- **Practice address:** 570 PARK AVE, 2ND FLOOR, EAST ORANGE, NJ 07017-1904
- **Practice address phone:** (973) 672-8573
- **Practice address fax:** (973) 675-0040
- **Mailing address:** 613 PARK AVE, EAST ORANGE, NJ 07017-1905
- **Mailing address phone:** (973) 672-2455
- **Mailing address fax:** (973) 675-0040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 25MA07308500 | NJ | Yes |

## Other

- **Enumeration date:** 02/12/2016
- **Last updated:** 02/12/2016