MEDICARE: ANGELIC CARE CENTER

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
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1568771566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELIC CARE CENTER

Provider Business Mailing Address
First Line	:	637 GEORGES RD
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-3331
Country	:	US
Telephone Number	:	732-246-8905
Fax Number	:

Provider Business Practice Location Address
First Line	:	637 GEORGES RD
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-3331
Country	:	US
Telephone Number	:	732-246-8905
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. MARY BERNADETTE GALVIN
Credential	:	MD
Telephone Number	:	908-307-8424

Provider Enumeration Date	:	09/26/2010
Last Update Date	:	09/26/2010

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Directions to “ANGELIC CARE CENTER ” Practice Location

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