Organization
PINEBROOK MEDICAL CENTER LLC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS STACK D.O (OWNER/DOCTOR)
(973) 808-3200
Entity
Organization
Contact information
Practice address
170 CHANGEBRIDGE ROAD, SUITE A-3, MONTVILLE, NJ 07045
(973) 808-3200
(973) 808-3202
Mailing address
170 CHANGEBRIDGE RD BLDG A3, MONTVILLE, NJ 07045-8802
(973) 808-3200
(973) 808-3202
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MB58292
NJ
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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