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General NPI Number Information
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NPI Number | 1508001827
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Entity Type | Organization
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Legal Business Name | PISCATAWAY HEALTHCARE PC
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Dates
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Enumeration Date | 12/16/2008
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Last Update Date | 12/16/2008
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Provider Practice Location Address
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Address Line | 366 VAIL AVE
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City | PISCATAWAY
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State | NJ
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Zip | 08854-1500
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Country | US
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Telephone | 732-968-2811
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Fax | 732-968-7769
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Provider Business Mailing Address
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Address Line | 366 VAIL AVE
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City | PISCATAWAY
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State | NJ
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Zip | 08854-1500
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Country | US
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Telephone | 732-968-2811
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Fax | 732-968-7769
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Authorized Official
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Title or Position | BUSINESS
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Name | ZAI M KARU
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Credential | ETC
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Telephone | 732-968-2811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 25MAO4025500
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License Number State | NJ
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