Provider Demographics
NPI:1477209070
Name:NEW JERSEY CENTER FOR PEDIATRIC NURSING CARE LLC
Entity Type:Organization
Organization Name:NEW JERSEY CENTER FOR PEDIATRIC NURSING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AVROHOM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIEROVITS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-994-4324
Mailing Address - Street 1:200 BLVD OF THE AMERICAS
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-994-4324
Mailing Address - Fax:
Practice Address - Street 1:94 STEVENS RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1490
Practice Address - Country:US
Practice Address - Phone:888-244-5373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric