Provider Demographics
NPI:1992463384
Name:MVP MEDICAL ASSOCIATES, PA
Entity type:Organization
Organization Name:MVP MEDICAL ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOJARES
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:732-531-4747
Mailing Address - Street 1:1803 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2974
Mailing Address - Country:US
Mailing Address - Phone:732-531-0100
Mailing Address - Fax:732-531-0144
Practice Address - Street 1:200 WYCKOFF ROAD
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724
Practice Address - Country:US
Practice Address - Phone:732-531-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MVP MEDICAL ASSOCIATES, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care