Provider Demographics
NPI:1427694991
Name:MEDICAL ARTS CENTER OF AMBOY
Entity type:Organization
Organization Name:MEDICAL ARTS CENTER OF AMBOY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-745-7911
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08862-0190
Mailing Address - Country:US
Mailing Address - Phone:732-376-0606
Mailing Address - Fax:732-376-1614
Practice Address - Street 1:333 MADISON AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4124
Practice Address - Country:US
Practice Address - Phone:732-376-0606
Practice Address - Fax:732-376-1614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty