Healthcare Provider Details

I. General information

NPI: 1982948303
Provider Name (Legal Business Name): RARITAN NH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 ROUTE 28
RARITAN NJ
08869-1127
US

IV. Provider business mailing address

102 REAGAN CT
LAKEWOOD NJ
08701-3263
US

V. Phone/Fax

Practice location:
  • Phone: 908-526-8950
  • Fax:
Mailing address:
  • Phone: 732-881-8940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number061809
License Number StateNJ

VIII. Authorized Official

Name: BENJAMIN KURLAND
Title or Position: CEO
Credential:
Phone: 732-881-8940