=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740195791
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RANCH HEALTH JERSEY CITY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2026
-----------------------------------------------------
Last Update Date | 08/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 196 PRINCETON HIGHTSTOWN ROAD BUILDING 2 SUITE 14B
-----------------------------------------------------
City | WEST WINDSOR
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-325-9084
-----------------------------------------------------
Fax | 908-460-6680
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 196 PRINCETON HIGHTSTOWN ROAD BUILDING 2 SUITE 14B
-----------------------------------------------------
City | WEST WINDSOR
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST
-----------------------------------------------------
Name | CECILIA WONG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-858-3672
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------