Family Practice of Middletown, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MB073124 Issued in NJ

Legal business name

FAMILY PRACTICE OF MIDDLETOWN, LLC

Practice address

170 Avenue at the CMN
Shrewsbury, NJ 07702-4803

Phone

(732) 720-9548

Fax

(732) 865-7735

NPI assigned

Jan 20, 2010

Organization subpart

No

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

Authorized official

Name

Gary B Kershner, D.O.

Title

President

Phone

(732) 720-9548

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1730410325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 AVENUE AT THE CMN",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024803",
            "telephone_number": "732-720-9548",
            "fax_number": "732-865-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 AVENUE AT THE CMN",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024803",
            "telephone_number": "732-720-9548",
            "fax_number": "732-865-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE OF MIDDLETOWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "KERSHNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-720-9548",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB073124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Esterov, P.A.C.
• Christopher J Fabricant, MD
• Chrissy Fabrico, LAC
• Natalie Fagan, PT, DPT
• George J Fahoury Jr., DPM
• Barbara Fane, LCSW ,BCD
• Regina Marie Farash, M.A.
• Shahid Waseem Farooqui, MD
• Pamela Farrow
• Jessica L Federici, LCSW

• Family Medicine Physician in Shrewsbury, NJ
• Providers in Shrewsbury, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.