Healthcare Provider Details

I. General information

NPI: 1962602912
Provider Name (Legal Business Name): SARAHCARE@WATCHUNG SQUARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 ROUTE 22 E
NORTH PLAINFIELD NJ
07060-3806
US

IV. Provider business mailing address

35 MARY ELLEN DR
EDISON NJ
08820-1108
US

V. Phone/Fax

Practice location:
  • Phone: 908-561-8888
  • Fax: 908-561-7222
Mailing address:
  • Phone: 908-591-3882
  • Fax: 908-222-8430

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: DR. JUAN CARLOS GRANA
Title or Position: PRESIDENT
Credential: DC
Phone: 908-591-3882