Provider Demographics
NPI:1053430280
Name:THE MEDICAL CENTER AT BUDD LAKE
Entity type:Organization
Organization Name:THE MEDICAL CENTER AT BUDD LAKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-691-9400
Mailing Address - Street 1:125 US HIGHWAY 46
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-2523
Mailing Address - Country:US
Mailing Address - Phone:973-691-9400
Mailing Address - Fax:973-691-3283
Practice Address - Street 1:125 US HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:BUDD LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07828-2523
Practice Address - Country:US
Practice Address - Phone:973-691-9400
Practice Address - Fax:973-691-3283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ757435Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER