OrganizationActive
Medical Diagnostic Associates, PA
NPI 1508128224 · Non-Pharmacy Dispensing Site · Summit, NJ
Provider details
- NPI number
- 1508128224
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Organization subpart
- No
- Authorized official
- Terry Dyer, Practice Administrator(732) 382-0091
- License
- 25MA06949800 (NJ)
Specialties & taxonomies
Suppliers
Practice location
99 Beauvoir Ave
Summit, NJ 07901-3533
Phone: (908) 608-1504
Fax: (908) 608-0078
Approximate (ZIP-level) locationGet directions
Mailing address
77 Brant Ave
Clark, NJ 07066-1560
Registry dates
- Enumerated
- 2012-06-08
- Last updated
- 2012-06-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.