Provider Demographics
NPI:1144665522
Name:SKYLAND MEDICAL CARE, PC
Entity type:Organization
Organization Name:SKYLAND MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAN
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:MOHSIN
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-684-0684
Mailing Address - Street 1:117 SEBER RD
Mailing Address - Street 2:2 B DOCTORS PARK
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1722
Mailing Address - Country:US
Mailing Address - Phone:908-684-0684
Mailing Address - Fax:908-684-1119
Practice Address - Street 1:117 SEBER RD
Practice Address - Street 2:2 B DOCTORS PARK
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1722
Practice Address - Country:US
Practice Address - Phone:908-684-0684
Practice Address - Fax:908-684-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care