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General NPI Number Information
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NPI Number | 1508989526
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Entity Type | Organization
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Legal Business Name | HEALTH GUARD
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 646 STATE ROUTE 18 BLDG B STE 110
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3722
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Country | US
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Telephone | 732-254-9155
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Fax |
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Provider Business Mailing Address
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Address Line | 34 ALPINE DR
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1276
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Country | US
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Telephone | 732-617-9251
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OF THE COMPANY
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Name | MR. VALERIY IZRAILOV
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Credential |
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Telephone | 732-254-9155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 7356901
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License Number State | NJ
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