Healthcare Provider Details
I. General information
NPI: 1306891791
Provider Name (Legal Business Name): CENTRAL JERSEY MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
275 HOBART ST
PERTH AMBOY NJ
08861-4310
US
IV. Provider business mailing address
PO BOX 1220
PERTH AMBOY NJ
08862-1220
US
V. Phone/Fax
- Phone: 732-376-9333
- Fax: 732-324-5765
- Phone: 732-376-6635
- Fax: 732-324-5765
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | 22864 |
| License Number State | NJ |
VIII. Authorized Official
Name: MRS.
MARTA
FERREIRA
Title or Position: HR DIRECTOR
Credential:
Phone: 732-376-6615