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General NPI Number Information
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NPI Number | 1710765391
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Entity Type | Organization
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Legal Business Name | LOCAL INFUSION HEALTH OF NJ PC
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 433 OLD HOOK RD UNIT 4
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City | EMERSON
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State | NJ
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Zip | 07630-1323
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Country | US
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Telephone | 844-509-1404
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 53303
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City | PHOENIX
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State | AZ
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Zip | 85072-3303
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Country | US
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Telephone | 844-614-2354
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Fax | 844-278-8635
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Authorized Official
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Title or Position | REIMBURSEMENT MANAGER
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Name | CHARLES MICHAEL BUCY
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Credential |
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Telephone | 717-383-0392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy 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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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