Provider Demographics
NPI:1144255506
Name:MADURA, PAUL P JR (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:P
Last Name:MADURA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08827-2535
Mailing Address - Country:US
Mailing Address - Phone:908-537-1042
Mailing Address - Fax:908-537-1043
Practice Address - Street 1:450 CHARLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08827-2535
Practice Address - Country:US
Practice Address - Phone:908-537-1042
Practice Address - Fax:908-537-1043
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2009-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03922600282N00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No282N00000XHospitalsGeneral Acute Care Hospital