Kendall Park Medical Group
Family Medicine in Kendall Park, New Jersey
1477784155- Practice location
- 3 Stanworth RD # A, Kendall Park, NJ 08824-1003
- Phone
- 732-940-0505
- Fax
- 732-940-1997
- Last updated
- July 29, 2009
Kendall Park Medical Group is a healthcare organization based in Kendall Park, NJ. Kendall Park Medical Group practices in Kendall Park, NJ. The NPI Number for Kendall Park Medical Group is 1477784155 and holds a License No. 25MA04235300 (NJ). The current practice location address for Kendall Park Medical Group is 3 Stanworth RD # A, Kendall Park, NJ 08824-1003 and can be reached out via phone at 732-940-0505 and via fax at 732-940-1997.
Provider Profile Details
- NPI Number
- 1477784155
- Provider Name
- Kendall Park Medical Group
- Provider Entity Type
- Organization
- Address
- 3 Stanworth RD # A, Kendall Park, NJ 08824-1003
- Phone Number
- 732-940-0505
- Fax Number
- 732-940-1997
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Organization Subpart
- No
- Authorized Official
- Dr. Jaime F Lara, MD · Physician · 732-940-0505
- Provider Enumeration Date
- July 29, 2009
- Last Update Date
- July 29, 2009
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 3 Stanworth RD # A
Kendall Park, NJ 08824-1003 - City
- Kendall Park
- State
- New Jersey
- Zip
- 08824-1003
- Phone Number
- 732-940-0505
- Fax Number
- 732-940-1997
Provider Business Mailing Address Details
- Address
- 3 Stanworth RD # A
Kendall Park, NJ 08824-1003 - City
- Kendall Park
- State
- NJ
- Zip
- 08824-1003
- Phone Number
- 732-940-0505
- Fax Number
- 732-940-1997
License Information
- License Number
- 25MA04235300
- License State
- NJ
- Taxonomy
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Family Medicine providers near Kendall Park, NJ
View all Family Medicine providers in Kendall Park →Frequently Asked Questions
What is the NPI number of Kendall Park Medical Group?
The NPI number of Kendall Park Medical Group is 1477784155. It was assigned on July 29, 2009 and is currently active in the NPPES registry.
What is the specialty of Kendall Park Medical Group?
Kendall Park Medical Group is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in NJ under license number 25MA04235300.
Where does Kendall Park Medical Group practice?
The practice location is 3 Stanworth RD # A, Kendall Park, NJ 08824-1003. The office can be reached at 732-940-0505 (phone) or 732-940-1997 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1477784155 directly on the NPPES registry website.