Organization
NORTHERN MECIAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRA MATCHIN (EXECUTIVE DIRECTOR)
(732) 238-3800
Entity
Organization
Contact information
Practice address
51 W PROSPECT ST, EAST BRUNSWICK, NJ 08816-5711
(732) 238-3800
(732) 238-2883
Mailing address
51 W PROSPECT ST, EAST BRUNSWICK, NJ 08816-5711
(732) 238-3800
(732) 238-2883
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
MA 039611
NJ
207R00000X
Internal Medicine Physician
25MA07937500
NJ
207R00000X
Internal Medicine Physician
Primary
25MB07663700
NJ
213E00000X
Podiatrist
25MD00274100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011574
GHI
NJ
01
—
1115857
HORIZON
NJ
01
—
4704191
CIGNA
NJ
01
—
7024826
AETNA
NJ
05
—
8706808
—
NJ
05
—
8942404
—
NJ
01
—
P3729381
UNITEDHEALTHCARE OXFORD
NJ
Enumeration date
07/05/2006
Last updated
09/11/2025
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