Provider Demographics
NPI:1972907772
Name:ALLIED PHYSICIANS OF SJ
Entity type:Organization
Organization Name:ALLIED PHYSICIANS OF SJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVNARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-692-7700
Mailing Address - Street 1:1206 W SHERMAN AVE
Mailing Address - Street 2:BUILDING 1 SUITE A
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-6911
Mailing Address - Country:US
Mailing Address - Phone:856-692-7700
Mailing Address - Fax:856-213-5403
Practice Address - Street 1:1206 W SHERMAN AVE
Practice Address - Street 2:BUILDING 1 SUITE A
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6911
Practice Address - Country:US
Practice Address - Phone:856-692-7700
Practice Address - Fax:856-213-5403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06786000207R00000X
NJ25MA044099000207RC0000X
NJ25MB04980000207RP1001X
NJ25MB07794500207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty