Organization
BMG EAST ORANGE LLC
Active
Other names
Urgent Care & Walk-in Medical Suite
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BLIMY JACOBS CREDENTIAL (BILLING & CREDENTIALING DIRECTOR)
(845) 662-2404
Entity
Organization
Contact information
Practice address
200 FREEWAY DR E STE 305, EAST ORANGE, NJ 07018
(973) 370-4000
(973) 370-4040
Mailing address
200 FREEWAY DR E STE 305, EAST ORANGE, NJ 07018-3809
(973) 370-4000
(862) 904-0044
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08818300
NJ
207RI0200X
Infectious Disease Physician
25MA08818300
NJ
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0630390
—
NJ
Enumeration date
10/12/2017
Last updated
12/30/2021
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