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NPI Code Detail

MEDICARE: HENRY J AUSTIN HEALTH CENTER, INC

MEDICARE: HENRY J AUSTIN HEALTH CENTER, INC
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
1261QF0400XFederally Qualified Health Center (FQHC)24227NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
124227OTHERNJSTATE LIC NUMBER

General Provider Information

NPI Number : 1225287113
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENRY J AUSTIN HEALTH CENTER, INC
Provider Business Mailing Address
First Line : 321 N WARREN ST
Second Line :
City : TRENTON
State : NJ
Zip : 08618-4741
Country : US
Telephone Number : 609-278-5900
Fax Number : 609-695-3532
Provider Business Practice Location Address
First Line : 1544 KUSER RD
Second Line : SUITE C 6& 7
City : HAMILTON
State : NJ
Zip : 08619-3830
Country : US
Telephone Number : 609-585-4606
Fax Number : 609-585-4608
Authorized Official
Title or Position : HR MANAGER
Name : ELIZABETH M YULL
Credential :
Telephone Number : 609-278-5950
Provider Enumeration Date : 09/16/2008
Last Update Date : 09/16/2008

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