Healthcare Provider Details

I. General information

NPI: 1275662017
Provider Name (Legal Business Name): CLINICAL HEALTH CARE ASSOCIATES OF NEW JERSEY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 ROUTE 70 E
CHERRY HILL NJ
08034-2413
US

IV. Provider business mailing address

409 ROUTE 70 E
CHERRY HILL NJ
08034-2413
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-6035
  • Fax: 856-427-0391
Mailing address:
  • Phone: 215-662-6035
  • Fax: 856-427-0391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: STACY GRECO
Title or Position: SR. ENROLLMENT MANAGER
Credential:
Phone: 223-341-8516