Healthcare Provider Details

I. General information

NPI: 1235183898
Provider Name (Legal Business Name): THE CENTER FOR KIDNEY CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1261 ROUTE 38 SUITE A
HAINESPORT NJ
08036
US

IV. Provider business mailing address

1261 ROUTE 38 SUITE A
HAINESPORT NJ
08036
US

V. Phone/Fax

Practice location:
  • Phone: 856-222-1975
  • Fax: 856-222-0165
Mailing address:
  • Phone: 856-222-1975
  • Fax: 856-222-0165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL JAMES CONRAD
Title or Position: PHYSICIAN
Credential: MD
Phone: 856-222-1975