Healthcare Provider Details

I. General information

NPI: 1437924297
Provider Name (Legal Business Name): MEDICAL CLINIC CARING INTERNATIONAL & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 WATCHUNG AVE
PLAINFIELD NJ
07060-1210
US

IV. Provider business mailing address

8 JENSEN LN
UNION NJ
07083-7925
US

V. Phone/Fax

Practice location:
  • Phone: 908-545-6670
  • Fax: 908-308-4960
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOSE POLANCO
Title or Position: OWNER
Credential: NP
Phone: 973-725-4078