Provider Demographics
NPI:1396858874
Name:HACKENSACK MERIDIAN URGENT CARE PLUS PC
Entity Type:Organization
Organization Name:HACKENSACK MERIDIAN URGENT CARE PLUS PC
Other - Org Name:JFK MEDICAL GROUP PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-807-0877
Mailing Address - Street 1:PO BOX 95000-7715
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-0001
Mailing Address - Country:US
Mailing Address - Phone:888-571-5280
Mailing Address - Fax:732-022-0914
Practice Address - Street 1:5 MARINE VIEW PLZ STE 101
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5756
Practice Address - Country:US
Practice Address - Phone:848-308-4612
Practice Address - Fax:848-308-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ635398Medicare PIN