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Organization

BLUE STAR MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. HR MANAGER (MANAGER)
(973) 777-0000
Entity
Organization

Contact information

Practice address
110 SQUIRE HILL RD, MONTCLAIR, NJ 07043-2516
(973) 777-0000
(973) 370-4040
Mailing address
110 SQUIRE HILL RD, MONTCLAIR, NJ 07043-2516
(973) 370-4000
(973) 370-4040

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM1300X
Multi-Specialty Clinic/Center
261QU0200X
Urgent Care Clinic/Center
Primary

Other

Enumeration date
01/02/2020
Last updated
07/29/2025
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