Provider Demographics
NPI:1245563758
Name:V CARE HEALTH ASSOCIATES, LLC
Entity Type:Organization
Organization Name:V CARE HEALTH ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAVANI
Authorized Official - Middle Name:DURGA
Authorized Official - Last Name:VIETLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-781-5485
Mailing Address - Street 1:1 WINDMILL CT
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-3146
Mailing Address - Country:US
Mailing Address - Phone:732-781-5485
Mailing Address - Fax:
Practice Address - Street 1:1 WINDMILL CT
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-3146
Practice Address - Country:US
Practice Address - Phone:732-781-5485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2016-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA069862207R00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0006734Medicaid
NJH55392Medicare UPIN
NJ055149Medicare PIN