Provider Demographics
NPI:1568771566
Name:ANGELIC CARE CENTER
Entity Type:Organization
Organization Name:ANGELIC CARE CENTER
Other - Org Name:ANGELIC MEDICAL OF NORTH BRUNSWICK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:BERNADETTE
Authorized Official - Last Name:GALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-307-8424
Mailing Address - Street 1:637 GEORGES RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3331
Mailing Address - Country:US
Mailing Address - Phone:732-246-8905
Mailing Address - Fax:
Practice Address - Street 1:637 GEORGES RD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3331
Practice Address - Country:US
Practice Address - Phone:732-246-8905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-26
Last Update Date:2010-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty