Healthcare Provider Details

I. General information

NPI: 1013312859
Provider Name (Legal Business Name): OCEAN COUNTY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2014
Last Update Date: 10/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 ROUTE 9 SUITE 1
LANOKA HARBOR NJ
08734-2818
US

IV. Provider business mailing address

411 ROUTE 9 SUITE 1
LANOKA HARBOR NJ
08734-2818
US

V. Phone/Fax

Practice location:
  • Phone: 609-971-3500
  • Fax: 609-971-3545
Mailing address:
  • Phone: 609-971-3500
  • Fax: 609-971-3545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT THOMPSON
Title or Position: OWNER
Credential: DC
Phone: 609-971-3500