Provider Demographics
NPI:1740214204
Name:OCEAN RENAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:OCEAN RENAL ASSOCIATES, P.A.
Other - Org Name:OCEAN RENAL ASSOCIATES, P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:I
Authorized Official - Last Name:IGLESIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-458-5067
Mailing Address - Street 1:210 JACK MARTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7771
Mailing Address - Country:US
Mailing Address - Phone:732-458-5067
Mailing Address - Fax:732-458-4962
Practice Address - Street 1:1617 ROUTE 88 W
Practice Address - Street 2:SUITE D-1
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3010
Practice Address - Country:US
Practice Address - Phone:732-458-5067
Practice Address - Fax:732-458-4962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9701OtherRAILROAD MEDICARE NUMBER
CA9701OtherRAILROAD MEDICARE NUMBER