Organization
RBIDC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MIDDLETON MD (PRESIDENT)
(732) 360-2700
Entity
Organization
Contact information
Practice address
3 HOSPITAL PLZ, SUITE 208, OLD BRIDGE, NJ 08857-3093
(732) 360-2700
(732) 360-2703
Mailing address
3 HOSPITAL PLZ, SUITE 208, OLD BRIDGE, NJ 08857-3093
(732) 360-2700
(732) 360-2703
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA28183
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1777203
—
NJ
Enumeration date
04/15/2008
Last updated
06/12/2008
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