Provider Demographics
NPI:1497198667
Name:ICARE INTERNAL MEDICINE
Entity Type:Organization
Organization Name:ICARE INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BINGHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-379-5980
Mailing Address - Street 1:493 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1061
Mailing Address - Country:US
Mailing Address - Phone:973-379-5980
Mailing Address - Fax:908-481-1888
Practice Address - Street 1:493 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1061
Practice Address - Country:US
Practice Address - Phone:973-379-5980
Practice Address - Fax:908-481-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08439400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00744324OtherRAIL ROAD
NJ0209163Medicaid
NJP00744324OtherRAIL ROAD