Provider Demographics
NPI:1629797451
Name:JERSEY SHORE HEALING
Entity Type:Organization
Organization Name:JERSEY SHORE HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AVROHOM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWINDER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:248-318-1275
Mailing Address - Street 1:5170 ROUTE 9 S
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3359
Mailing Address - Country:US
Mailing Address - Phone:732-278-6907
Mailing Address - Fax:
Practice Address - Street 1:5170 ROUTE 9 S
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3359
Practice Address - Country:US
Practice Address - Phone:732-278-6907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty