Healthcare Provider Details

I. General information

NPI: 1952589152
Provider Name (Legal Business Name): METROPOLITAN HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BROADWAY
BAYONNE NJ
07002-3518
US

IV. Provider business mailing address

300 BROADWAY
BAYONNE NJ
07002-3518
US

V. Phone/Fax

Practice location:
  • Phone: 201-243-0666
  • Fax: 201-243-0016
Mailing address:
  • Phone: 201-243-0666
  • Fax: 201-243-0016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number408210
License Number StateNJ

VIII. Authorized Official

Name: MS. JAMIE INN
Title or Position: ADMINISTRATOR
Credential: MA/CSW
Phone: 201-243-0666