Organization
MIDDLETOWN MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN TANIS (EXECUTIVE DIRECTOR OF CONTRACT MGMT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
600 HWY 35, RED BANK, NJ 07701-5018
(732) 706-1300
(732) 706-1313
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 533-8762
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
10/19/2010
Last updated
12/30/2019
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