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General NPI Number Information
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NPI Number | 1386665578
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Entity Type | Organization
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Legal Business Name | RENAL GROUP OF CENTRAL NEW JERSEY
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 1350 HAMILTON ST
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City | SOMERSET
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State | NJ
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Zip | 08873-3341
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Country | US
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Telephone | 732-246-2626
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Fax | 732-249-5480
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Provider Business Mailing Address
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Address Line | 1350 HAMILTON ST
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City | SOMERSET
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State | NJ
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Zip | 08873-3341
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Country | US
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Telephone | 732-246-2626
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Fax | 732-249-5480
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | TRINA GARCIA
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Credential |
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Telephone | 732-246-9348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA46077
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License Number State | NJ
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