Healthcare Provider Details

I. General information

NPI: 1700292380
Provider Name (Legal Business Name): REGIONAL CANCER CARE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2014
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BRIER HILL COURT, K2 BUILDING
EAST BRUNSWICK NJ
08816-3341
US

IV. Provider business mailing address

500 FRANK W BURR BLVD SUITE 560 MAILBOX # 29
TEANECK NJ
07666
US

V. Phone/Fax

Practice location:
  • Phone: 732-390-0003
  • Fax: 732-390-0350
Mailing address:
  • Phone: 560-624-5269
  • Fax: 201-621-6931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TERRILL JORDAN
Title or Position: PRESIDENT
Credential:
Phone: 201-510-0910