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
1601 TILTON RD, NORTHFIELD, NJ 08225-1877
(609) 272-0655
(609) 272-9317
Mailing address
22 N FRANKLIN BLVD, 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
25MA03856300
NJ
213E00000X
Podiatrist
Primary
25MD00197100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8139504
—
NJ
Enumeration date
04/09/2014
Last updated
04/09/2014
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