Deptford Internal Medicine Associates LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DEPTFORD INTERNAL MEDICINE ASSOCIATES LLC

Practice address

1132 Cooper Street Suite Three
Deptford, NJ 08096-3014

Phone

(856) 848-8060

Fax

(856) 848-8038

NPI assigned

Oct 3, 2018

Last updated

Jul 14, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Imran Azam Mirza, MDNPI 1376573204

Title

Owner

Phone

(732) 743-5910

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Imran A Mirza, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Deptford, NJ
  • NPI 1376573204
  Medicare reassignment Care Compare group NPD Authorized official
• Brenna Anne Eadie, PA-C

  • Physician Assistant
  • Deptford, NJ
  • NPI 1497517023
  Medicare reassignment Care Compare group
• Sarah Von Lange

  • Physician Assistant
  • Deptford, NJ
  • NPI 1942975610
  Medicare reassignment

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1346725561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "MICKLETON",
            "state": "NJ",
            "postal_code": "080560069",
            "telephone_number": "856-848-8060",
            "fax_number": "856-848-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 COOPER STREET SUITE THREE",
            "city": "DEPTFORD",
            "state": "NJ",
            "postal_code": "080963014",
            "telephone_number": "856-848-8060",
            "fax_number": "856-848-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPTFORD INTERNAL MEDICINE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "IMRAN",
        "authorized_official_middle_name": "AZAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-743-5910",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25MA08024700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dale Stein and Associates, OD, PC
• Daniel & Max, LLC
• Daniel G. Timms DDS & Jeffrey Koslow DMD PA
• Valerie Debenedictis
• Deptford Family Dental PA
• Deptford Township School District
• Alyssa Sue Destefano, RN
• Kristina Diakos, LPN
• Stacy L Digneo, PHARM.D.
• Dr. Mo's Eye Care

• Primary Care Clinic/Center in Deptford, NJ
• Providers in Deptford, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.