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General NPI Number Information
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NPI Number | 1740744366
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Entity Type | Organization
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Legal Business Name | GENESIS HEALTHCARE UNITED STATES
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 105 MONUMENT PL
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City | TRENTON
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State | NJ
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Zip | 08618-3955
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Country | US
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Telephone | 800-813-9036
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Fax | 866-410-7649
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Provider Business Mailing Address
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Address Line | 105 MONUMENT PL
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City | TRENTON
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State | NJ
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Zip | 08618-3955
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Country | US
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Telephone | 800-813-9036
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Fax | 866-410-7649
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ERICKA VICTORIA VERNON
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Credential | ND, PSYD, MFCT
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Telephone | 800-813-9036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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