Millville Internal and Specialty Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA07827400 Issued in NJ

Legal business name

MILLVILLE INTERNAL AND SPECIALTY MEDICINE LLC

Practice address

608 N High St
Millville, NJ 08332-3025

Phone

(856) 825-8080

Fax

(856) 327-8571

NPI assigned

Jun 11, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Ravi Hajeebu

Title

Practice Manager

Phone

(215) 768-2265

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1497075527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 N HIGH ST",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083323025",
            "telephone_number": "856-825-8080",
            "fax_number": "856-327-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 N HIGH ST",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083323025",
            "telephone_number": "856-825-8080",
            "fax_number": "856-327-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLVILLE INTERNAL AND SPECIALTY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "HAJEEBU",
        "authorized_official_first_name": "RAVI",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "215-768-2265",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07827400",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "26MA08374000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Ali Miletta, OD
• Carol L. Miller, LCSW, MFT
• Millville Board of Education
• Millville Chiropractic Center
• Millville Family Dental PA
• Millville Internal Medicine, LLC
• Millville Medical Center
• Millville Meridian, LP (Millville Center)
• Millville Rescue Squad
• Joseph Michael Misyak, MSW, CSW, LCADC

• Internal Medicine Physician in Millville, NJ
• Providers in Millville, 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 Oct 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.