MEDICARE: EAST ORANGE VAMC

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	261QV0200X	VA Clinic/Center

General Provider Information

NPI Number	:	1215982772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST ORANGE VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94438
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4438
Country	:	US
Telephone Number	:	717-277-6565
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 N GILBERT ST
Second Line	:	BLDG 4, 1ST FLOOR, SUITE 4101
City	:	TINTON FALLS
State	:	NJ
Zip	:	07701-4955
Country	:	US
Telephone Number	:	717-277-6565
Fax Number	:

Authorized Official
Title or Position	:	NPI TEAM MEMBER
Name	:	ERIN POTTER
Credential	:
Telephone Number	:	202-382-2579

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	01/10/2023

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Directions to “EAST ORANGE VAMC ” Practice Location

Language	Start Address	Practice Location

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