Provider Demographics
NPI:1063531093
Name:MONROE INTERNAL MEDICINE ASSOCIATES, LLC
Entity type:Organization
Organization Name:MONROE INTERNAL MEDICINE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKRANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-383-6985
Mailing Address - Street 1:147 STULTS LN
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5809
Mailing Address - Country:US
Mailing Address - Phone:732-390-5654
Mailing Address - Fax:
Practice Address - Street 1:254 CRANBURY HALF ACRE RD
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-3746
Practice Address - Country:US
Practice Address - Phone:609-860-0800
Practice Address - Fax:609-860-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08160400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty