Provider Demographics
NPI:1194832840
Name:AFFILIATED MEDICAL ASSOCIATES OF MORRISTOWN, P.A.
Entity type:Organization
Organization Name:AFFILIATED MEDICAL ASSOCIATES OF MORRISTOWN, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, AFFILIATED MEDICAL ASSOC
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:G
Authorized Official - Last Name:DESHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-538-5844
Mailing Address - Street 1:25 LINDSLEY DRIVE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4456
Mailing Address - Country:US
Mailing Address - Phone:973-538-5844
Mailing Address - Fax:973-267-0181
Practice Address - Street 1:25 LINDSLEY DRIVE
Practice Address - Street 2:SUITE 311
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4456
Practice Address - Country:US
Practice Address - Phone:973-538-5844
Practice Address - Fax:973-267-0181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTIN