Healthcare Provider Details

I. General information

NPI: 1023481983
Provider Name (Legal Business Name): SHAHNAWAZ ADULT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2015
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 MERIDIAN RD
EDISON NJ
08820-2823
US

IV. Provider business mailing address

36 MERIDIAN RD
EDISON NJ
08820-2823
US

V. Phone/Fax

Practice location:
  • Phone: 732-662-1200
  • Fax: 732-662-1205
Mailing address:
  • Phone: 732-662-1200
  • Fax: 732-662-1205

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: PANKAJ BHATT
Title or Position: ADMINISTRATOR
Credential:
Phone: 732-662-1200