Provider Demographics
NPI:1437591963
Name:SHORE RENAL CARE
Entity Type:Organization
Organization Name:SHORE RENAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEPHROLOGIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DEPALMA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-773-2203
Mailing Address - Street 1:1617 ROUTE 88 W
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3010
Mailing Address - Country:US
Mailing Address - Phone:732-458-1903
Mailing Address - Fax:732-458-1906
Practice Address - Street 1:1617 ROUTE 88 W
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3010
Practice Address - Country:US
Practice Address - Phone:732-458-1903
Practice Address - Fax:732-458-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-25
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08928600207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty