Provider Demographics
NPI:1437649845
Name:CITYLIFE CLINICS NJ, PC
Entity Type:Organization
Organization Name:CITYLIFE CLINICS NJ, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LANG
Authorized Official - Middle Name:
Authorized Official - Last Name:ASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-556-5908
Mailing Address - Street 1:601 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2635
Mailing Address - Country:US
Mailing Address - Phone:127-099-9273
Mailing Address - Fax:
Practice Address - Street 1:44 JONES ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:267-819-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care