Healthcare Provider Details

I. General information

NPI: 1114661584
Provider Name (Legal Business Name): EAST JERSEY HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2022
Last Update Date: 04/22/2022
Certification Date: 04/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 SAINT GEORGES AVE
RAHWAY NJ
07065-2007
US

IV. Provider business mailing address

2005 SAINT GEORGES AVE
RAHWAY NJ
07065-2007
US

V. Phone/Fax

Practice location:
  • Phone: 908-232-2273
  • Fax: 908-232-1439
Mailing address:
  • Phone: 908-232-2273
  • Fax: 908-232-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. KAMRAN TASHAROFI
Title or Position: OWNER
Credential: MD
Phone: 908-232-2273