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General NPI Number Information
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NPI Number | 1942210026
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Entity Type | Organization
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Legal Business Name | BRACHA INC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | 1048 GROVE ST
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City | ELIZABETH
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State | NJ
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Zip | 07202
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Country | US
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Telephone | 908-354-0002
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Fax | 908-354-0033
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Provider Business Mailing Address
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Address Line | 1048 GROVE ST
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City | ELIZABETH
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State | NJ
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Zip | 07202
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Country | US
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Telephone | 908-354-0002
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Fax | 908-354-0033
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ZEV FISHMAN
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Credential |
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Telephone | 908-354-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 62007X
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License Number State | NJ
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