Provider Demographics
NPI:1659619849
Name:INTEGRATED HEALTHCARE PISCATAWAY LLC
Entity Type:Organization
Organization Name:INTEGRATED HEALTHCARE PISCATAWAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KINGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-283-1900
Mailing Address - Street 1:220 CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3940
Mailing Address - Country:US
Mailing Address - Phone:732-283-1900
Mailing Address - Fax:732-791-9566
Practice Address - Street 1:220 CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3940
Practice Address - Country:US
Practice Address - Phone:732-283-1900
Practice Address - Fax:732-791-9566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty