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General NPI Number Information
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NPI Number | 1861749707
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Entity Type | Organization
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Legal Business Name | ROOSEVELT MEDICAL CENTER , L.L.C
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 01/22/2022
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Provider Practice Location Address
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Address Line | 237 ROOSEVELT AVE
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City | CARTERET
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State | NJ
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Zip | 07008-3533
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Country | US
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Telephone | 732-541-2141
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Fax | 732-541-1038
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Provider Business Mailing Address
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Address Line | 237 ROOSEVELT AVE
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City | CARTERET
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State | NJ
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Zip | 07008-3533
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Country | US
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Telephone | 732-541-2141
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Fax | 732-541-1038
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Authorized Official
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Title or Position | CREDENTAILING COORDINATOR
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Name | MS. ANU SINGH
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Credential |
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Telephone | 732-541-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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