Provider Demographics
NPI:1538224936
Name:QUALITY MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:QUALITY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-404-1823
Mailing Address - Street 1:29 S NEW YORK RD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9692
Mailing Address - Country:US
Mailing Address - Phone:609-404-1823
Mailing Address - Fax:609-404-1853
Practice Address - Street 1:29 S NEW YORK RD
Practice Address - Street 2:SUITE 700
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9692
Practice Address - Country:US
Practice Address - Phone:609-404-1823
Practice Address - Fax:609-404-1853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207R00000X207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG82922Medicare UPIN
NJ065209Medicare UPIN