Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Autumn Ridge Primary Care LLC

Organization Internal Medicine Physician · NPI 1306471065

Autumn Ridge Primary Care LLC is an Internal Medicine Physician in Wall Township, New Jersey. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3350 Hwy 138 Ste 217
Wall Township, NJ 07719-9694
Phone: (732) 974-1980
Fax: (732) 974-8020
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1306471065
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Janice Siciliano — President · (732) 974-1980
NPI enumeratedMarch 3, 2020
Last updated in NPPESAugust 31, 2020
Certification dateAugust 31, 2020
Mailing address3350 Hwy 138 Ste 217, Wall Township, NJ 07719-9694

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