Healthcare Provider Details

I. General information

NPI: 1841561172
Provider Name (Legal Business Name): APOLLO HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N ARLINGTON AVE
EAST ORANGE NJ
07017-4010
US

IV. Provider business mailing address

515 N ARLINGTON AVE
EAST ORANGE NJ
07017-4010
US

V. Phone/Fax

Practice location:
  • Phone: 973-674-1500
  • Fax:
Mailing address:
  • Phone: 973-674-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MOSHE FROST
Title or Position: CONTROLLER
Credential:
Phone: 732-364-2672