Healthcare Provider Details

I. General information

NPI: 1316664907
Provider Name (Legal Business Name): CONSTANT CARE HEALTH OF NEW JERSEY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 GEORGE ST STE 320
NEW BRUNSWICK NJ
08901-2091
US

IV. Provider business mailing address

317 GEORGE ST STE 320
NEW BRUNSWICK NJ
08901-2091
US

V. Phone/Fax

Practice location:
  • Phone: 317-658-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAVID KLAIN
Title or Position: MANAGER
Credential:
Phone: 317-658-5000