| Mid Jersey Medical Associates, Pa | |
|
1 Ethel Rd Suite 107b Edison NJ 08817-2838 | |
| (732) 287-2020 | |
| Not Available |
| Full Name | Mid Jersey Medical Associates, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Ethel Rd, Edison, New Jersey |
| Authorized Official Name and Position | Machia Uthappa (OWNER) |
| Authorized Official Contact | 7322872020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Jersey Medical Associates, Pa 1 Ethel Rd Suite 107b Edison NJ 08817-2838 Ph: (732) 287-2020 | Mid Jersey Medical Associates, Pa 1 Ethel Rd Suite 107b Edison NJ 08817-2838 Ph: (732) 287-2020 |
| NPI Number | 1184722431 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 09/29/2011 |
| Medicare PECOS PAC ID | 0143225805 |
|---|---|
| Medicare Enrollment ID | O20061002000465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184722431 | NPI | - | NPPES |
| 1124098678 | Other | INDIVIDUAL NPI NUMBER | |
| 7894406 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MA061302 (New Jersey) | Primary |
| Provider Name | Machia M Uthappa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124098678 PECOS PAC ID: 2062457997 Enrollment ID: I20050622000300 |
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