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General NPI Number Information
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NPI Number | 1720743529
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Entity Type | Organization
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Legal Business Name | CARBON HEALTH PRIMARY CARE OF NEW JERSEY PA
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Dates
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Enumeration Date | 11/05/2021
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 3371 BRUNSWICK PIKE UNIT 56
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-1375
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Country | US
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Telephone | 732-515-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 300 CALIFORNIA ST FL 7
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-1415
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR CONTRACTING & CREDENTIALIN
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Name | MARLEY PAGE
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Credential |
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Telephone | 844-234-7741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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