SECOND STREET MEDICAL ASSOCIATES NPI 1679522775

NPI Information

  • NPI: 1679522775
  • Provider Name: SECOND STREET MEDICAL ASSOCIATES
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 386 2ND ST
    HACKENSACK, NJ
    ZIP 07601
  • Phone: (201) 342-1877

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NPI Details

SECOND STREET MEDICAL ASSOCIATES is a primary care clinic center in Hackensack, NJ. SECOND STREET MEDICAL ASSOCIATES NPI is 1679522775. The provider is registered as an organization entity type.

The provider's business location address is:

386 2ND ST
HACKENSACK, NJ
ZIP 07601-731
Phone: (201) 342-1877
Fax: (201) 342-1879

The provider's authorized official is Philip G Woodham .
The authorized official title is Owner and has the following contact phone number (201) 342-1877.

The enumeration date for this NPI number is 5/8/2006 and was last updated on 3/20/2013.

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 CareMA67550NEW 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
1X83358MEDICARE UPINNEW JERSEY
2065943MEDICARE PINNEW 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: 3/30/2025

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