Provider Demographics
NPI:1992469910
Name:UNITED MEDICAL GROUP 1 LLP
Entity type:Organization
Organization Name:UNITED MEDICAL GROUP 1 LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VERA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:908-469-1677
Mailing Address - Street 1:452 BERGEN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-2250
Mailing Address - Country:US
Mailing Address - Phone:908-469-1677
Mailing Address - Fax:908-469-1678
Practice Address - Street 1:129 1ST ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07206-1781
Practice Address - Country:US
Practice Address - Phone:908-469-1677
Practice Address - Fax:908-469-1678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty