MEDICARE: EMPOWER U OUTPATIENT SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	261QC1500X	Community Health Clinic/Center
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1023695491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWER U OUTPATIENT SERVICES

Provider Business Mailing Address
First Line	:	43 GRAND COVE WAY
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-7223
Country	:	US
Telephone Number	:	908-907-7777
Fax Number	:	855-500-3848

Provider Business Practice Location Address
First Line	:	1 BETHANY RD STE 92
Second Line	:
City	:	HAZLET
State	:	NJ
Zip	:	07730-1669
Country	:	US
Telephone Number	:	855-500-8348
Fax Number	:	855-500-3848

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. MARLON W GRAY
Credential	:	EDD
Telephone Number	:	908-907-7777

Provider Enumeration Date	:	03/24/2021
Last Update Date	:	10/25/2024

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