Provider Demographics
NPI:1659557296
Name:CEDAR HARBOR MEDICAL DAY CARE CENTER
Entity Type:Organization
Organization Name:CEDAR HARBOR MEDICAL DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:723-364-8050
Mailing Address - Street 1:545 E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-1571
Mailing Address - Country:US
Mailing Address - Phone:908-298-8588
Mailing Address - Fax:
Practice Address - Street 1:545 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-1571
Practice Address - Country:US
Practice Address - Phone:908-298-8588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ908115261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care