Healthcare Provider Details

I. General information

NPI: 1114921509
Provider Name (Legal Business Name): WARREN MEDICENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W UNION AVE STE 107
BOUND BROOK NJ
08805-1166
US

IV. Provider business mailing address

601 W UNION AVE STE 107
BOUND BROOK NJ
08805-1166
US

V. Phone/Fax

Practice location:
  • Phone: 732-469-3627
  • Fax: 732-667-3708
Mailing address:
  • Phone: 732-469-3627
  • Fax: 732-667-3708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: HAROLD B. EHRLICH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 908-240-2393