MEDICARE: AAA SCREENING INCQ

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	:	1821239229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAA SCREENING INCQ

Provider Business Mailing Address
First Line	:	197 ROUTE 18 STE 3000
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-1440
Country	:	US
Telephone Number	:	718-338-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	197 ROUTE 18 STE 3000
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-1440
Country	:	US
Telephone Number	:	718-338-6300
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID SRULEVICH
Credential	:
Telephone Number	:	718-338-6300

Provider Enumeration Date	:	03/13/2009
Last Update Date	:	03/13/2009

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Directions to “AAA SCREENING INCQ ” Practice Location

Language	Start Address	Practice Location

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