Organization
RELIANCE MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON M REGIS MD (OWNER)
(609) 272-0655
Entity
Organization
Contact information
Practice address
331 E JIMMIE LEEDS RD, GALLOWAY, NJ 08205-4123
(609) 652-6016
(609) 652-2406
Mailing address
22 N FRANKLIN BLVD, 2ND FLOOR, PLEASANTVILLE, NJ 08232-2547
(609) 272-0655
(609) 272-9317
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA07552100
NJ
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA05992900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8139504
—
NJ
Enumeration date
04/17/2014
Last updated
04/17/2014
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