MEDICARE: VNA HEALTH GROUP OF NEW JERSEY, 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	251E00000X	Home Health Agency	71502	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71502	OTHER	NJ	HOME CARE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912964818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VNA HEALTH GROUP OF NEW JERSEY, LLC

Provider Business Mailing Address
First Line	:	23 MAIN STREET
Second Line	:	SUITE D1
City	:	HOLMDEL
State	:	NJ
Zip	:	07733-2136
Country	:	US
Telephone Number	:	732-224-6914
Fax Number	:	732-784-9710

Provider Business Practice Location Address
First Line	:	1433 HOOPER AVENUE
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-6813
Country	:	US
Telephone Number	:	732-818-6872
Fax Number	:	732-784-9916

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. PETER GAYLORD
Credential	:
Telephone Number	:	800-862-3330

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	12/08/2023

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