Healthcare Provider Details

I. General information

NPI: 1508019241
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: 10/28/2008
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: 856-429-0505
  • Fax:
Mailing address:
  • Phone: 856-429-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number StateNJ
# 5
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateNJ

VIII. Authorized Official

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