Organization Name: | 1198 MEDICAL ASSOCIATES LLC |
NPI Number: | 1003291980 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES STOKES (CEO) |
Mailing Address: | 1198 Lakewood Rd Ste 101 Toms River |
State: | NJ US |
Postal Code: | 087532237 |
Phone Number: | 7327366559 |
Fax Number: | |
NPI Enumeration Date: | 07/21/2015 |
NPI Last Update Date: | 07/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |