Basic Information
| Provider Information | |||||||||
| NPI: | 1427084466 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 135 RARITAN CENTER PKWY | ||||||||
| Address2: | CONCENTRA MEDICAL CENTER | ||||||||
| City: | EDISON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088373625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322255454 | ||||||||
| FaxNumber: | 7324170003 | ||||||||
| Practice Location | |||||||||
| Address1: | 135 RARITAN CENTER PKWY | ||||||||
| Address2: | CONCENTRA MEDICAL CENTER | ||||||||
| City: | EDISON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088373625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322255454 | ||||||||
| FaxNumber: | 7324170003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 11/16/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 25MP00084300 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.