Provider Demographics
NPI:1922498708
Name:PROCARE PERINATAL ASSOCIATES
Entity Type:Organization
Organization Name:PROCARE PERINATAL ASSOCIATES
Other - Org Name:PROCARE PERINATAL ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEVETA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-340-7736
Mailing Address - Street 1:46 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5968
Mailing Address - Country:US
Mailing Address - Phone:908-340-7736
Mailing Address - Fax:
Practice Address - Street 1:239 BRIDGE ST
Practice Address - Street 2:BLDG E, 2ND FLOOR
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2292
Practice Address - Country:US
Practice Address - Phone:908-340-7736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROCARE PERINATAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-30
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09337800207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty