Organization
INTEGRATIVE FUNCTIONAL MEDICINE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI THOMAS (MD)
(201) 967-8425
Entity
Organization
Contact information
Practice address
292 BLOOMFIELD AVE, 2ND FLOOR, MONTCLAIR, NJ 07042-3624
(973) 928-8909
(201) 967-8425
Mailing address
41 WATCHUNG PLZ, SUITE 345, MONTCLAIR, NJ 07042-4117
(201) 967-8425
(201) 967-8443
Taxonomy
Speciality
Code
Description
License number
State
2081P0004X
Spinal Cord Injury Medicine Physician
Primary
25MA07295900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005466
—
NJ
Enumeration date
05/03/2010
Last updated
05/03/2010
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