Provider Demographics
NPI:1154483121
Name:MEDICAL CARE OF NORTHERN JERSEY INC
Entity type:Organization
Organization Name:MEDICAL CARE OF NORTHERN JERSEY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:V
Authorized Official - Last Name:PUZINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-334-8010
Mailing Address - Street 1:3799 US HIGHWAY 46
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1055
Mailing Address - Country:US
Mailing Address - Phone:973-334-8010
Mailing Address - Fax:973-402-9030
Practice Address - Street 1:3799 US HIGHWAY 46
Practice Address - Street 2:SUITE 209
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1055
Practice Address - Country:US
Practice Address - Phone:973-334-8010
Practice Address - Fax:973-402-9030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA39824207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1520008Medicaid
NJE57645Medicare UPIN
NJ1520008Medicaid