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ISLAND MEDICAL PROFESSIONAL ASSOCIATION NPI 1265549539


NPI Information

NPI: 1265549539
Provider Name: ISLAND MEDICAL PROFESSIONAL ASSOCIATION
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 31D0117316

Address:
1812 LONG BEACH BLVD
SHIP BOTTOM, NJ
ZIP 08008
Phone: (609) 494-2323
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ISLAND MEDICAL PROFESSIONAL ASSOCIATION is a family medicine in Ship Bottom, NJ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ISLAND MEDICAL PROFESSIONAL ASSOCIATION NPI is 1265549539. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1812 LONG BEACH BLVD
SHIP BOTTOM, NJ
ZIP 08008-443
Phone: (609) 494-2323
Fax: (609) 494-4141

The provider's authorized official is James Noland Suddeth .
The authorized official title is President and has the following contact phone number (609) 494-2323.

The CLIA number assigned to this NPI record is 31D0117316 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/24/2006 and was last updated on 7/5/2011.


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
1207Q00000XFamily MedicineYes

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
16175601MEDICAIDNEW 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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