Provider Demographics
NPI:1295727576
Name:SMITHVILLE MEDICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:SMITHVILLE MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMCHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:THADHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-652-0555
Mailing Address - Street 1:28 SOUTH NEW YORK RD
Mailing Address - Street 2:SUITE C 4
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9753
Mailing Address - Country:US
Mailing Address - Phone:609-652-0555
Mailing Address - Fax:609-652-1414
Practice Address - Street 1:28 S NEW YORK RD
Practice Address - Street 2:SUITE C4
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9695
Practice Address - Country:US
Practice Address - Phone:609-652-0555
Practice Address - Fax:609-652-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty