MEDICARE: MY GOAL

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	251X00000X	Supports Brokerage Agency
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1831740950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY GOAL

Provider Business Mailing Address
First Line	:	51 WAVERLY PL
Second Line	:
City	:	MONMOUTH JUNCTION
State	:	NJ
Zip	:	08852-2705
Country	:	US
Telephone Number	:	877-886-9462
Fax Number	:	877-886-9462

Provider Business Practice Location Address
First Line	:	51 WAVERLY PL
Second Line	:
City	:	MONMOUTH JUNCTION
State	:	NJ
Zip	:	08852-2705
Country	:	US
Telephone Number	:	877-886-9462
Fax Number	:	877-886-9462

Authorized Official
Title or Position	:	FOUNDER AND EXECUTIVE DIRECTOR
Name	:	DR. GENEVIEVE KUMAPLEY
Credential	:
Telephone Number	:	877-886-9462

Provider Enumeration Date	:	09/20/2019
Last Update Date	:	09/20/2019

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Directions to “MY GOAL ” Practice Location

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