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General NPI Number Information
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NPI Number | 1073628327
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Entity Type | Organization
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Legal Business Name | ESI MEDICAL, LLC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 2517 HIGHWAY 35 SUITE J201
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City | MANASQUAN
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State | NJ
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Zip | 08736
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Country | US
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Telephone | 732-292-0101
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Fax | 732-292-9911
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Provider Business Mailing Address
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Address Line | 2517 HIGHWAY 35 SUITE J201
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City | MANASQUAN
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State | NJ
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Zip | 08736
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Country | US
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Telephone | 732-292-0101
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Fax | 732-292-9911
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | PHILIP G PASSES
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Credential | DO
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Telephone | 732-292-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HP0070900
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License Number State | NJ
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