Organization
MEND PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARVEY KENNETH BUCHOLTZ MD (PRESIDENT)
(732) 549-7470
Entity
Organization
Contact information
Practice address
2 LINCOLN HWY, 501, EDISON, NJ 08820-3961
(732) 549-7470
(732) 494-8596
Mailing address
2 LINCOLN HWY, 501, EDISON, NJ 08820-3961
(732) 549-7470
(732) 494-8596
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279900620
—
NJ
01
—
CF1917
RAILROAD MEDICARE
NJ
01
—
ME445889
MEDICARE GROUP #
NJ
Enumeration date
02/06/2006
Last updated
01/04/2012
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