MEDICARE: REGALCARE MANAGEMENT GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1063877819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGALCARE MANAGEMENT GROUP

Provider Business Mailing Address
First Line	:	5 BARLOW RD
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3022
Country	:	US
Telephone Number	:	732-561-3327
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 BARLOW RD
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3022
Country	:	US
Telephone Number	:	732-561-3327
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELIYAHU MIRLIS
Credential	:
Telephone Number	:	973-796-6175

Provider Enumeration Date	:	12/21/2015
Last Update Date	:	12/21/2015

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Directions to “REGALCARE MANAGEMENT GROUP ” Practice Location

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