Provider Demographics
NPI:1770240707
Name:NJUCARE LLC
Entity Type:Organization
Organization Name:NJUCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAGDY
Authorized Official - Middle Name:F
Authorized Official - Last Name:MAHMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-210-4000
Mailing Address - Street 1:110 SQUIRE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-2516
Mailing Address - Country:US
Mailing Address - Phone:973-370-4000
Mailing Address - Fax:973-370-4040
Practice Address - Street 1:141 CHESTNUT ST STE 201
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-2282
Practice Address - Country:US
Practice Address - Phone:973-210-4000
Practice Address - Fax:973-370-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-24
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care