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General NPI Number Information
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NPI Number | 1164700936
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Entity Type | Organization
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Legal Business Name | ROBERT W. DEVINE JR.
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Dates
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Enumeration Date | 07/28/2011
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Last Update Date | 07/28/2011
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Provider Practice Location Address
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Address Line | 126 AINSWORTH AVE
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1211
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Country | US
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Telephone | 732-354-0089
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Fax |
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Provider Business Mailing Address
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Address Line | 126 AINSWORTH AVE
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1211
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Country | US
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Telephone | 732-354-0089
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Fax |
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Authorized Official
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Title or Position | HHA/CAREGIVER
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Name | MRS. ROSALIA MARCOS RODRIGO
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Credential | CHHA/CNA
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Telephone | 732-354-0089
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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 | 26NH12487200
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License Number State | NJ
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