Healthcare Provider Details

I. General information

NPI: 1952350522
Provider Name (Legal Business Name): ATLANTIC COAST RHEUMATOLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442D COMMONS WAY
TOMS RIVER NJ
08755-6429
US

IV. Provider business mailing address

PO BOX 1244
TOMS RIVER NJ
08754-1244
US

V. Phone/Fax

Practice location:
  • Phone: 732-505-3510
  • Fax: 732-505-5308
Mailing address:
  • Phone: 732-349-2795
  • Fax: 732-349-2795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA58633800
License Number StateNJ

VIII. Authorized Official

Name: RAJAT DHAR
Title or Position: OWNER
Credential: M.D.
Phone: 732-505-3510