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NPI Code Detail

MEDICARE: MIDDLESEX COMMUNITY MEDICALCARE, LLC

MEDICARE: MIDDLESEX COMMUNITY MEDICALCARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2500XMedical Specialty Clinic/Center25MA08109500NJ

General Provider Information

NPI Number : 1114173028
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDDLESEX COMMUNITY MEDICALCARE, LLC
Provider Business Mailing Address
First Line : 530 UNION AVE
Second Line : SUITE #2
City : MIDDLESEX
State : NJ
Zip : 08846-1934
Country : US
Telephone Number : 732-667-3287
Fax Number : 732-667-3289
Provider Business Practice Location Address
First Line : 530 UNION AVE
Second Line : SUITE #2
City : MIDDLESEX
State : NJ
Zip : 08846-1934
Country : US
Telephone Number : 732-667-3287
Fax Number : 732-667-3289
Authorized Official
Title or Position : PRESIDENT
Name : DR. GEETA YALAMANCHI
Credential : M.D.
Telephone Number : 732-667-3287
Provider Enumeration Date : 08/12/2008
Last Update Date : 08/12/2008

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Directions to “MIDDLESEX COMMUNITY MEDICALCARE, LLC ” Practice Location

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