Healthcare Provider Details
I. General information
NPI: 1952142127
Provider Name (Legal Business Name): UNIVERSAL HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2024
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 N COUNTY LINE RD
JACKSON NJ
08527-0247
US
IV. Provider business mailing address
20 N COUNTY LINE RD
JACKSON NJ
08527-0247
US
V. Phone/Fax
- Phone: 732-961-8524
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
IDAN
BENNY
GOLDSTEIN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 732-961-8524