Provider Demographics
NPI:1225369952
Name:EMERGICARE OF CENTRAL NEW JERSEY, LLC
Entity Type:Organization
Organization Name:EMERGICARE OF CENTRAL NEW JERSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-602-0244
Mailing Address - Street 1:1030 SAINT GEORGES AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1390
Mailing Address - Country:US
Mailing Address - Phone:732-602-0244
Mailing Address - Fax:732-602-2577
Practice Address - Street 1:1030 SAINT GEORGES AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1390
Practice Address - Country:US
Practice Address - Phone:732-602-0244
Practice Address - Fax:732-602-2577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care