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General NPI Number Information
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NPI Number | 1487039806
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Entity Type | Organization
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Legal Business Name | WIKARE HEALTH CLINIC INC.
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 11/11/2016
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Provider Practice Location Address
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Address Line | 101 ROUTE 130 S MADISON BLDGE, STE 308
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City | CINNAMINSON
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State | NJ
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Zip | 08077-2845
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Country | US
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Telephone | 856-389-5579
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Fax |
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Provider Business Mailing Address
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Address Line | 101 ROUTE 130 S MADISON BLDGE, STE 308
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City | CINNAMINSON
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State | NJ
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Zip | 08077-2845
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Country | US
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Telephone | 856-389-5579
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. NINA C. LANE
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Credential | APN
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Telephone | 856-389-5579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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