Provider Demographics
NPI:1003181074
Name:REGIONAL CANCER CARE ASSOCIATES
Entity Type:Organization
Organization Name:REGIONAL CANCER CARE ASSOCIATES
Other - Org Name:NORTHERN NEW JERSEY CANCER ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BHAVESH
Authorized Official - Middle Name:V
Authorized Official - Last Name:BALAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-431-8400
Mailing Address - Street 1:326 PROFESSIONAL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-7904
Mailing Address - Country:US
Mailing Address - Phone:732-431-8400
Mailing Address - Fax:732-431-0114
Practice Address - Street 1:326 PROFESSIONAL VIEW DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-7904
Practice Address - Country:US
Practice Address - Phone:732-431-8400
Practice Address - Fax:732-431-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6682390016Medicare NSC