Provider Demographics
NPI:1396742102
Name:RINGWOOD MEDICAL ASSOCIATES PA
Entity type:Organization
Organization Name:RINGWOOD MEDICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-962-6200
Mailing Address - Street 1:52 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2020
Mailing Address - Country:US
Mailing Address - Phone:973-962-6200
Mailing Address - Fax:973-962-0046
Practice Address - Street 1:52 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:RINGWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07456-2020
Practice Address - Country:US
Practice Address - Phone:973-962-6200
Practice Address - Fax:973-962-0046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB48584207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8421330OtherAETNA PPO GROUP#
NJ0040274OtherAETNA HMO GROUP#
NJCL5898OtherRAILROAD MEDICARE GROUP#
NJCL5898OtherRAILROAD MEDICARE GROUP#