Provider Demographics
NPI:1881835049
Name:FAMILY CARE OF JACKSON, PC
Entity Type:Organization
Organization Name:FAMILY CARE OF JACKSON, PC
Other - Org Name:FAMILY HEALTHCARE AT BARTELY CORNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VICE PRES OF MEDICAL AFFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-294-2780
Mailing Address - Street 1:161 BARTLEY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1241
Mailing Address - Country:US
Mailing Address - Phone:732-294-2540
Mailing Address - Fax:732-409-2621
Practice Address - Street 1:161 BARTLEY RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1241
Practice Address - Country:US
Practice Address - Phone:732-294-2540
Practice Address - Fax:732-409-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty