Provider Demographics
NPI:1124186879
Name:MED-CARE OF EAST HANOVER, INC.
Entity Type:Organization
Organization Name:MED-CARE OF EAST HANOVER, INC.
Other - Org Name:MED-CARE OF EAST HANOVER
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCOLAMIELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-939-7161
Mailing Address - Street 1:245 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073
Mailing Address - Country:US
Mailing Address - Phone:973-882-3545
Mailing Address - Fax:973-882-0457
Practice Address - Street 1:325 ROUTE 10
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936
Practice Address - Country:US
Practice Address - Phone:973-386-1133
Practice Address - Fax:973-386-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty