=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831998905
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METROPOLITAN LIFE CORE CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2025
-----------------------------------------------------
Last Update Date | 03/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 BROADWAY
-----------------------------------------------------
City | BAYONNE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-243-0555
-----------------------------------------------------
Fax | 201-243-1836
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 BROADWAY
-----------------------------------------------------
City | BAYONNE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-243-0555
-----------------------------------------------------
Fax | 201-243-1836
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | JAMIE RYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 201-243-0555
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------