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General NPI Number Information
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NPI Number | 1013573047
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Entity Type | Organization
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Legal Business Name | ADAPTIVE HEALTHCARE PA
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Dates
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Enumeration Date | 05/15/2019
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Last Update Date | 05/30/2019
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Provider Practice Location Address
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Address Line | 1075 STEPHENSON AVE STE D-2
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City | OCEANPORT
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State | NJ
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Zip | 07757-1242
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Country | US
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Telephone | 833-223-2266
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Fax | 732-783-0323
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Provider Business Mailing Address
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Address Line | 1075 STEPHENSON AVE STE D-2
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City | OCEANPORT
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State | NJ
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Zip | 07757-1242
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Country | US
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Telephone | 833-223-2266
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Fax | 732-783-0323
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JEREMY WELWARTH
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Credential |
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Telephone | 833-223-2266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number |
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License Number State |
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