Provider Demographics
NPI:1528302650
Name:PRACTICE ASSOCIATES
Entity type:Organization
Organization Name:PRACTICE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:973-971-4179
Mailing Address - Street 1:100 MADISON AVE
Mailing Address - Street 2:HEART SUCCESS PROGRAM INTERBOX #5
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6136
Mailing Address - Country:US
Mailing Address - Phone:973-971-4179
Mailing Address - Fax:973-898-1600
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:HEART SUCCESS PROGRAM INTERMAILBOX 5
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07962
Practice Address - Country:US
Practice Address - Phone:973-971-4179
Practice Address - Fax:973-898-1600
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00397100282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital