Healthcare Provider Details

I. General information

NPI: 1235456849
Provider Name (Legal Business Name): CRITICAL CARE UNIT RESOURCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE HACKENSACK UNIVERSITY MEDICAL CENTER
HACKENSACK NJ
07601
US

IV. Provider business mailing address

192 PROSPECT AVE
HACKENSACK NJ
07601-2204
US

V. Phone/Fax

Practice location:
  • Phone: 201-880-0700
  • Fax:
Mailing address:
  • Phone: 201-880-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ROBERT LEE
Title or Position: PRESIDENT
Credential: MD
Phone: 201-880-0700