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General NPI Number Information
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NPI Number | 1376638064
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Entity Type | Organization
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Legal Business Name | HACKENSACK MERIDIAN AMBULATORY CARE, INC.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1759 ROUTE 88 SUITE 100 LAURELTON PLAZA
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City | BRICK
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State | NJ
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Zip | 08723
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Country | US
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Telephone | 732-206-8100
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Fax | 732-206-8101
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Provider Business Mailing Address
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Address Line | 1759 ROUTE 88 SUITE 100 LAURELTON PLAZA
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City | BRICK
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State | NJ
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Zip | 08723
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Country | US
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Telephone | 732-206-8100
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Fax | 732-206-8101
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT
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Name | MICHELLE MENDELSON
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Credential | RN, MSN
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Telephone | 732-751-3713
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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 | 22366
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License Number State | NJ
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