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Organization
ISLAND MEDICAL ASSOCIATES,PA
Active
Organization
ISLAND MEDICAL ASSOCIATES,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER O KUPONIYI MD (INTERNAL MEDICINE)
(609) 568-5000
Entity
Organization
Contact information
Practice address
2626 TILTON RD, EGG HARBOR TWP, NJ 08234-1829
(609) 568-5000
(609) 568-5015
Mailing address
2626 TILTON RD, EGG HARBOR TWP, NJ 08234-1829
(609) 568-5000
(609) 568-5015
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
25MA05948800
NJ
2080A0000X
Pediatric Adolescent Medicine Physician
25MA04695100
NJ
Other
Enumeration date
08/13/2006
Last updated
03/08/2011
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