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General NPI Number Information
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NPI Number | 1235097783
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Entity Type | Organization
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Legal Business Name | MEDIVANCE CARE
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 180 TICES LN STE 104C
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1345
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Country | US
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Telephone | 732-354-0185
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Fax |
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Provider Business Mailing Address
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Address Line | 180 TICES LN STE 104C
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1345
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Country | US
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Telephone | 732-354-0185
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LYUDMILA ASHUROVA
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Credential |
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Telephone | 732-977-3088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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