Provider Demographics
NPI:1508001827
Name:PISCATAWAY HEALTHCARE PC
Entity Type:Organization
Organization Name:PISCATAWAY HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS
Authorized Official - Prefix:
Authorized Official - First Name:ZAI
Authorized Official - Middle Name:M
Authorized Official - Last Name:KARU
Authorized Official - Suffix:
Authorized Official - Credentials:ETC
Authorized Official - Phone:732-968-2811
Mailing Address - Street 1:366 VAIL AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-1500
Mailing Address - Country:US
Mailing Address - Phone:732-968-2811
Mailing Address - Fax:732-968-7769
Practice Address - Street 1:366 VAIL AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-1500
Practice Address - Country:US
Practice Address - Phone:732-968-2811
Practice Address - Fax:732-968-7769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO4025500261QC1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56797Medicare UPIN