Healthcare Provider Details

I. General information

NPI: 1447315502
Provider Name (Legal Business Name): REGIONAL CANCER CARE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLARA MAASS DR STE 200
BELLEVILLE NJ
07109-3550
US

IV. Provider business mailing address

500 FRANK W BURR BLVD STE 560
TEANECK NJ
07666-6804
US

V. Phone/Fax

Practice location:
  • Phone: 973-751-8880
  • Fax: 973-751-8950
Mailing address:
  • Phone: 973-751-8880
  • Fax: 973-751-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRILL JORDAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 201-510-0910