Organization
MID JERSEY MEDICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACHIA UTHAPPA MD (OWNER)
(732) 287-2020
Entity
Organization
Contact information
Practice address
1 ETHEL RD, SUITE 107B, EDISON, NJ 08817-2838
(732) 287-2020
Mailing address
1 ETHEL RD, SUITE 107B, EDISON, NJ 08817-2838
(732) 287-2020
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MA061302
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124098678
INDIVIDUAL NPI NUMBER
—
05
—
7894406
—
NJ
Enumeration date
09/20/2006
Last updated
09/29/2011
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