Basic Information
| Provider Information | |||||||||
| NPI: | 1295261568 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL HEALTH CENTER OF MIDDLETOWN, INC | ||||||||
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| OtherOrganizationName: | MEDICAL HEALTH CENTER OF MIDDLETOWN | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1270 HIGHWAY 35 | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077482014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326153900 | ||||||||
| FaxNumber: | 7326150865 | ||||||||
| Practice Location | |||||||||
| Address1: | 1270 HIGHWAY 35 | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326153900 | ||||||||
| FaxNumber: | 7326150185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2017 | ||||||||
| LastUpdateDate: | 05/14/2018 | ||||||||
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| AuthorizedOfficialLastName: | CLEMENTE | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7326153900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 25MA05272000 | NJ | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 25MA06412300 | NJ | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 363LA2200X | 26NN09409300 | NJ | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 207Q00000X | 25MB07926900 | NJ | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.