Provider Demographics
NPI:1043939754
Name:SUBURBAN HEALTH CLINIC OF TOMS RIVER
Entity Type:Organization
Organization Name:SUBURBAN HEALTH CLINIC OF TOMS RIVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:856-287-1952
Mailing Address - Street 1:SUBURBAN HEALTH CLINIC OF TOMS RIVER
Mailing Address - Street 2:10 MULE RD
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5028
Mailing Address - Country:US
Mailing Address - Phone:732-797-9944
Mailing Address - Fax:
Practice Address - Street 1:SUBURBAN HEALTH CLINIC OF TOMS RIVER
Practice Address - Street 2:10 MULE RD
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5028
Practice Address - Country:US
Practice Address - Phone:732-797-9944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center