Provider Demographics
NPI:1114914694
Name:HOPE COMMUNITY CANCER CENTER, LLC
Entity Type:Organization
Organization Name:HOPE COMMUNITY CANCER CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:VERNOUSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-390-7888
Mailing Address - Street 1:210 S. SHORE RD.
Mailing Address - Street 2:STE 102-106
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223-1271
Mailing Address - Country:US
Mailing Address - Phone:609-390-7888
Mailing Address - Fax:609-390-2614
Practice Address - Street 1:210 S. SHORE RD.
Practice Address - Street 2:STE 102-106
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1271
Practice Address - Country:US
Practice Address - Phone:609-390-7888
Practice Address - Fax:609-390-2614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG53110Medicare UPIN
NJP40919Medicare UPIN
NJQ20105Medicare UPIN
NJG66877Medicare UPIN
NJF36925Medicare UPIN
NJ4670600001Medicare NSC