Healthcare Provider Details

I. General information

NPI: 1669828950
Provider Name (Legal Business Name): PLAZA ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 05/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BLACK WALNUT WAY
MARLBORO NJ
07746-2047
US

IV. Provider business mailing address

3 BLACK WALNUT WAY
MARLBORO NJ
07746-2047
US

V. Phone/Fax

Practice location:
  • Phone: 732-308-0716
  • Fax:
Mailing address:
  • Phone: 732-308-0716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: RITU CHITKARA
Title or Position: PRESIDENT
Credential:
Phone: 732-308-0716