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NEPTUNE ADULT MEDICINE LLC NPI 1144476771


NPI Information

NPI: 1144476771
Provider Name: NEPTUNE ADULT MEDICINE LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 31D0675496

Address:
1812 CORLIES AVENUE
NEPTUNE, NJ
ZIP 07753
Phone: (732) 988-3336
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NEPTUNE ADULT MEDICINE LLC is a clinic center in Neptune, NJ. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). NEPTUNE ADULT MEDICINE LLC NPI is 1144476771. The provider is registered as an organization entity type.

The provider's business location address is:

1812 CORLIES AVENUE
NEPTUNE, NJ
ZIP 07753
Phone: (732) 988-3336
Fax: (732) 776-8668

The provider's authorized official is Kimberly Atienza .
The authorized official title is Physician and has the following contact phone number (732) 988-3336.

The CLIA number assigned to this NPI record is 31D0675496 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/14/2008 and was last updated on 3/19/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareMA079626NEW JERSEYNo
2261Q00000XClinic/CenterMA079626NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1I38313MEDICARE UPINNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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