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NPI Code Detail

MEDICARE: RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM

MEDICARE: RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM
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
1207RX0202XMedical Oncology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518904929
Entity Type Code : Organization
Provider Name (Legal Business Name) : RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM
Provider Business Mailing Address
First Line : 66 W GILBERT ST
Second Line :
City : RED BANK
State : NJ
Zip : 07701
Country : US
Telephone Number : 732-212-0051
Fax Number : 732-212-0713
Provider Business Practice Location Address
First Line : 195 LITTLE ALBANY ST
Second Line :
City : NEW BRUNSWICK
State : NJ
Zip : 08901-1914
Country : US
Telephone Number : 732-235-6777
Fax Number : 732-235-7355
Authorized Official
Title or Position : DIRECTOR OF REVENUE CYCLE
Name : BRENDA LAWRENCE
Credential :
Telephone Number : 732-235-6070
Provider Enumeration Date : 06/02/2006
Last Update Date : 01/18/2021

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