Healthcare Provider Details

I. General information

NPI: 1417016189
Provider Name (Legal Business Name): R & D HEALTH MANAGEMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 FIFTH AVENUE
HASKELL NJ
07420-1075
US

IV. Provider business mailing address

25 FIFTH AVENUE
HASKELL NJ
07420-1075
US

V. Phone/Fax

Practice location:
  • Phone: 973-839-6000
  • Fax: 973-839-7145
Mailing address:
  • Phone: 973-839-6000
  • Fax: 973-839-7145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number061621
License Number StateNJ

VIII. Authorized Official

Name: MR. DAVID E RUCK
Title or Position: EXEC VP
Credential:
Phone: 973-839-6000