Healthcare Provider Details

I. General information

NPI: 1225369952
Provider Name (Legal Business Name): EMERGICARE OF CENTRAL NEW JERSEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 SAINT GEORGES AVE SUITE 201
AVENEL NJ
07001-1390
US

IV. Provider business mailing address

1030 SAINT GEORGES AVE SUITE 201
AVENEL NJ
07001-1390
US

V. Phone/Fax

Practice location:
  • Phone: 732-602-0244
  • Fax: 732-602-2577
Mailing address:
  • Phone: 732-602-0244
  • Fax: 732-602-2577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. STUART M HOMER
Title or Position: PRESIDENT
Credential: MD
Phone: 732-602-0244