Provider Demographics
NPI:1033473939
Name:CONNECTED CARE LIMITED LIABILITY
Entity Type:Organization
Organization Name:CONNECTED CARE LIMITED LIABILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-753-7763
Mailing Address - Street 1:411 COMMERCE LN
Mailing Address - Street 2:
Mailing Address - City:WEST BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08091-9254
Mailing Address - Country:US
Mailing Address - Phone:856-753-7763
Mailing Address - Fax:856-753-7714
Practice Address - Street 1:411 COMMERCE LN
Practice Address - Street 2:
Practice Address - City:WEST BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08091-9254
Practice Address - Country:US
Practice Address - Phone:856-753-7763
Practice Address - Fax:856-753-7714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty