Healthcare Provider Details
I. General information
NPI: 1164553665
Provider Name (Legal Business Name): FIRST HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/08/2007
Last Update Date: 06/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
540 BORDENTOWN AVE
SOUTH AMBOY NJ
08879-1544
US
IV. Provider business mailing address
4557 US HIGHWAY 9 SUITE 202
HOWELL NJ
07731-3382
US
V. Phone/Fax
- Phone: 732-553-1600
- Fax: 732-553-1601
- Phone: 732-886-1900
- Fax: 732-886-1950
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | 508310 |
| License Number State | NJ |
VIII. Authorized Official
Name:
YAAKOV
FRIEDMAN
Title or Position: MANAGING MEMBER
Credential:
Phone: 732-886-1900