Healthcare Provider Details

I. General information

NPI: 1861958811
Provider Name (Legal Business Name): OCEAN HEALTH INITIATIVES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 JACKSON STREET SUITE E
FREEHOLD NJ
07728
US

IV. Provider business mailing address

3600 ROUTE 66 SUITE 400
NEPTUNE NJ
07753
US

V. Phone/Fax

Practice location:
  • Phone: 732-363-6655
  • Fax:
Mailing address:
  • Phone: 732-363-6655
  • Fax: 732-455-5798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: THERESA BERGER
Title or Position: CEO
Credential: MD, CEO
Phone: 732-363-6655