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NPI Code Detail

MEDICARE: COMMUNITY MEDICAL CARE LLC

MEDICARE: COMMUNITY MEDICAL CARE LLC
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
1207Q00000XFamily Medicine Physician25MA05186600NJ

General Provider Information

NPI Number : 1649356577
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY MEDICAL CARE LLC
Provider Business Mailing Address
First Line : 500 WESTFIELD AVE
Second Line :
City : ELIZABETH
State : NJ
Zip : 07208-1642
Country : US
Telephone Number : 908-994-1500
Fax Number :
Provider Business Practice Location Address
First Line : 500 WESTFIELD AVE
Second Line :
City : ELIZABETH
State : NJ
Zip : 07208-1642
Country : US
Telephone Number : 908-994-1500
Fax Number :
Authorized Official
Title or Position : MANAGING PARTNER
Name : MR. EDWARD RAKLER
Credential : PA
Telephone Number : 908-994-1500
Provider Enumeration Date : 10/31/2006
Last Update Date : 05/20/2009

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Directions to “COMMUNITY MEDICAL CARE LLC ” Practice Location

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