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Organization

MEDICAL INTERNISTS ASSOC. PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIE PARKER (OFFICE MANAGER)
(201) 797-4503
Entity
Organization

Contact information

Practice address
17-15 MAPLE AVE, FAIR LAWN, NJ 07410-1552
(201) 797-4503
(201) 797-4270
Mailing address
17-15 MAPLE AVE, FAIR LAWN, NJ 07410-1552
(201) 797-4503
(201) 797-4270

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2843102
NJ
Enumeration date
10/26/2006
Last updated
04/20/2008
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