Provider Demographics
NPI:1174581334
Name:ATLANTIC HYPERBARIC ASSOCIATES,LLC
Entity type:Organization
Organization Name:ATLANTIC HYPERBARIC ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMERGENCY MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-971-6015
Mailing Address - Street 1:PO BOX 7313
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-7313
Mailing Address - Country:US
Mailing Address - Phone:800-290-5309
Mailing Address - Fax:803-434-4354
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07962
Practice Address - Country:US
Practice Address - Phone:973-971-6015
Practice Address - Fax:973-401-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8363706Medicaid
NJ026623Medicare PIN