Healthcare Provider Details

I. General information

NPI: 1568737534
Provider Name (Legal Business Name): REGIONAL CANCER CARE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2012
Last Update Date: 04/21/2024
Certification Date: 04/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 SPARTA AVE STE 130
SPARTA NJ
07871-1791
US

IV. Provider business mailing address

123 NEWTON SPARTA RD
NEWTON NJ
07860-2769
US

V. Phone/Fax

Practice location:
  • Phone: 973-726-0005
  • Fax: 973-726-4668
Mailing address:
  • Phone: 973-579-1524
  • Fax: 973-579-1524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRILL JORDAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 201-510-0910