Healthcare Provider Details

I. General information

NPI: 1275672610
Provider Name (Legal Business Name): NEW JERSEY HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 MORRIS AVE SUITE 2A
UNION NJ
07083-4852
US

IV. Provider business mailing address

2780 MORRIS AVE SUITE 2A
UNION NJ
07083-4852
US

V. Phone/Fax

Practice location:
  • Phone: 908-686-3300
  • Fax: 908-687-4747
Mailing address:
  • Phone: 908-686-3300
  • Fax: 908-687-4747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. CHIU-MAN POON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 908-687-3300