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1902892359

NPI Code Detail

MEDICARE: STRATEGIC LONG TERM CARE OF NEW JERSEY AT DELAIRE LLC

MEDICARE: STRATEGIC LONG TERM CARE OF NEW JERSEY AT DELAIRE 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
1	314000000X	Skilled Nursing Facility	062017	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60009731	OTHER	NJ	HORIZON NJ HEALTH
2	92649	OTHER	NJ	AMERICAID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4422127	OTHER	NJ	AETNA (TRADITIONAL)
5	315200	OTHER	NJ	HORIZON BC/BS (SKILLED)
6	UN000012000	OTHER	NJ	AMERICHOICE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	2884135	OTHER	NJ	AETNA (HMO)
9	A420707	OTHER	NJ	OXFORD
10	001162	OTHER	NJ	HORIZON BC/BS (SUBACUTE)
11	12243	OTHER	NJ	WELLCHOICE OF NJ

General Provider Information

NPI Number	:	1902892359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRATEGIC LONG TERM CARE OF NEW JERSEY AT DELAIRE LLC

Provider Business Mailing Address
First Line	:	400 W STIMPSON AVE
Second Line	:
City	:	LINDEN
State	:	NJ
Zip	:	07036-4434
Country	:	US
Telephone Number	:	908-862-3399
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 W STIMPSON AVE
Second Line	:
City	:	LINDEN
State	:	NJ
Zip	:	07036-4434
Country	:	US
Telephone Number	:	908-862-3399
Fax Number	:

Authorized Official
Title or Position	:	LNHA
Name	:	JOHN PILEK
Credential	:
Telephone Number	:	908-862-3399

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	09/16/2013

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Directions to “STRATEGIC LONG TERM CARE OF NEW JERSEY AT DELAIRE LLC ” Practice Location

Language	Start Address	Practice Location

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