Healthcare Provider Details

I. General information

NPI: 1609407212
Provider Name (Legal Business Name): ARCHANGEL MICHAEL COPTIC ORTHODOX CHURCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2020
Last Update Date: 02/01/2020
Certification Date: 02/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CHURCH RD
HOWELL NJ
07731-2402
US

IV. Provider business mailing address

7 CHURCH RD
HOWELL NJ
07731-2402
US

V. Phone/Fax

Practice location:
  • Phone: 732-613-0100
  • Fax:
Mailing address:
  • Phone: 732-613-0100
  • Fax:

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: SAMY S BASSILY
Title or Position: TREASURER
Credential:
Phone: 732-690-1575