Provider Demographics
NPI:1053329607
Name:M&C MEDICAL VENTURES, LLC
Entity Type:Organization
Organization Name:M&C MEDICAL VENTURES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:INGRASSIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-933-2232
Mailing Address - Street 1:276 ORIENTAL PL
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1700
Mailing Address - Country:US
Mailing Address - Phone:201-933-2232
Mailing Address - Fax:201-933-2242
Practice Address - Street 1:276 ORIENTAL PL
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-1700
Practice Address - Country:US
Practice Address - Phone:201-933-2232
Practice Address - Fax:201-933-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5783440001Medicare NSC