MEDICARE: OCEAN COUNTY FAMILY CARE, P.A.

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821019787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN COUNTY FAMILY CARE, P.A.

Provider Business Mailing Address
First Line	:	2290 W COUNTY LINE RD
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-2267
Country	:	US
Telephone Number	:	732-942-4455
Fax Number	:	732-942-4459

Provider Business Practice Location Address
First Line	:	2290 W COUNTY LINE RD
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-2267
Country	:	US
Telephone Number	:	732-942-4455
Fax Number	:	732-942-4459

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOANNE MCKEOWN
Credential	:
Telephone Number	:	732-942-4455

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	01/29/2008

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