# MEDICOR LIFESTYLE MEDICINE, P.A

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

## Provider details

- **NPI number:** 1831678887
- **Authorized official:** MR. JOHN E PUGH (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (908) 243-5002

## Contact information

- **Practice address:** 331 US HIGHWAY 206, HILLSBOROUGH, NJ 08844-4781
- **Practice address phone:** (908) 243-5004
- **Practice address fax:** (908) 904-1403
- **Mailing address:** 225 JACKSON ST, BRIDGEWATER, NJ 08807-3060
- **Mailing address phone:** (908) 243-5004
- **Mailing address fax:** (908) 904-1403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC3500X | Cardiac Rehabilitation Registered Nurse | — | NULL | Yes |
| 163WC3500X | Cardiac Rehabilitation Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 08/10/2018
- **Last updated:** 08/10/2018