Healthcare Provider Details

I. General information

NPI: 1063906121
Provider Name (Legal Business Name): VIRTUAL CARE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 PATERSON PLANK RD FL 1
SECAUCUS NJ
07094-3242
US

IV. Provider business mailing address

100 WALNUT AVE STE 210
CLARK NJ
07066-1247
US

V. Phone/Fax

Practice location:
  • Phone: 973-370-2860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAMALESH SHAH
Title or Position: OWNER
Credential: MD
Phone: 201-803-3397