| Hawthorne Integrated Medicine, Llc | |
|
219 Lafayette Ave Hawthorne NJ 07506-1904 | |
| (973) 423-9100 | |
| (973) 423-1339 |
| Full Name | Hawthorne Integrated Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 219 Lafayette Ave, Hawthorne, New Jersey |
| Authorized Official Name and Position | John Gregg (PRESIDENT/OWNER) |
| Authorized Official Contact | 9734239100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawthorne Integrated Medicine, Llc 219 Lafayette Ave Hawthorne NJ 07506-1904 Ph: (973) 423-9100 | Hawthorne Integrated Medicine, Llc 219 Lafayette Ave Hawthorne NJ 07506-1904 Ph: (973) 423-9100 |
| NPI Number | 1730505074 |
|---|---|
| Provider Enumeration Date | 03/11/2014 |
| Last Update Date | 03/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730505074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MB08249300 (New Jersey) | Primary |
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