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General NPI Number Information
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NPI Number | 1891219226
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Entity Type | Organization
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Legal Business Name | MY DOC JERSEY URGENT CARE LLC
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Dates
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Enumeration Date | 07/27/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 210 PASSAIC ST
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City | GARFIELD
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State | NJ
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Zip | 07026-1355
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Country | US
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Telephone | 862-295-3501
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Fax |
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Provider Business Mailing Address
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Address Line | 210 PASSAIC ST
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City | GARFIELD
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State | NJ
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Zip | 07026-1355
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Country | US
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Telephone | 862-295-3501
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Fax |
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Authorized Official
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Title or Position | DEPUTY MANAGER
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Name | JULIE MARINO
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Credential |
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Telephone | 862-295-3501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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