Healthcare Provider Details

I. General information

NPI: 1972667228
Provider Name (Legal Business Name): USCG SAMUEL J CALL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MUNRO AVE
CAPE MAY NJ
08204-5000
US

IV. Provider business mailing address

1 MUNRO AVE
CAPE MAY NJ
08204-5000
US

V. Phone/Fax

Practice location:
  • Phone: 609-898-6610
  • Fax: 609-898-6962
Mailing address:
  • Phone: 609-898-6610
  • Fax: 609-898-6962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1100X
TaxonomyMilitary/U.S. Coast Guard Outpatient Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KJERSTI A KOSKINEN
Title or Position: REGIONAL PRACTICE DIRECTOR
Credential: MD
Phone: 609-898-6957