Healthcare Provider Details

I. General information

NPI: 1114914694
Provider Name (Legal Business Name): HOPE COMMUNITY CANCER CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 02/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S. SHORE RD. STE 102-106
MARMORA NJ
08223-1271
US

IV. Provider business mailing address

210 S. SHORE RD. STE 102-106
MARMORA NJ
08223-1271
US

V. Phone/Fax

Practice location:
  • Phone: 609-390-7888
  • Fax: 609-390-2614
Mailing address:
  • Phone: 609-390-7888
  • Fax: 609-390-2614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD VERNOUSKI
Title or Position: PRACTICE MANAGER
Credential:
Phone: 609-390-7888