Provider Demographics
NPI:1821019787
Name:OCEAN COUNTY FAMILY CARE, P.A.
Entity Type:Organization
Organization Name:OCEAN COUNTY FAMILY CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEOWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-942-4455
Mailing Address - Street 1:2290 W COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2267
Mailing Address - Country:US
Mailing Address - Phone:732-942-4455
Mailing Address - Fax:732-942-4459
Practice Address - Street 1:2290 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2267
Practice Address - Country:US
Practice Address - Phone:732-942-4455
Practice Address - Fax:732-942-4459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7060807Medicaid
NJ7060807Medicaid
NJ1212830001Medicare NSC