Healthcare Provider Details

I. General information

NPI: 1225072689
Provider Name (Legal Business Name): WARREN HEALTH CARE ALLIANCE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 MEMORIAL PKWY BUILDING 100, SUITE 4
PHILLIPSBURG NJ
08865-2748
US

IV. Provider business mailing address

10 BRASS CASTLE RD
WASHINGTON NJ
07882-4327
US

V. Phone/Fax

Practice location:
  • Phone: 908-454-2707
  • Fax: 908-454-2597
Mailing address:
  • Phone: 908-835-1910
  • Fax: 908-835-1886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GERARD J DELMONICO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 908-859-6568