Matawan Medical Center LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MB08392800 Issued in NJ

Legal business name

MATAWAN MEDICAL CENTER LLC

Practice address

158 Main St
Suite 101
Matawan, NJ 07747-4104

Phone

(732) 970-6161

Fax

(732) 970-6163

NPI assigned

Mar 29, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Magda Ghabras, D.O.

Title

Physician

Phone

(732) 970-6161

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1093030454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 MAIN ST",
            "address_2": "SUITE 101",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077474104",
            "telephone_number": "732-970-6161",
            "fax_number": "732-970-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 MAIN ST",
            "address_2": "SUITE 101",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077474104",
            "telephone_number": "732-970-6161",
            "fax_number": "732-970-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATAWAN MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "GHABRAS",
        "authorized_official_first_name": "MAGDA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "732-970-6161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB08392800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0222453",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Matawan, NJ
• Providers in Matawan, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.