Provider Demographics
NPI:1013945609
Name:JERSEY HEALTHCARE RESOURCES, LLC
Entity Type:Organization
Organization Name:JERSEY HEALTHCARE RESOURCES, LLC
Other - Org Name:JERSEY HEALTHCARE RESOURCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PINELES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-489-7400
Mailing Address - Street 1:55 S NEWMAN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3211
Mailing Address - Country:US
Mailing Address - Phone:201-489-9000
Mailing Address - Fax:201-489-9040
Practice Address - Street 1:55 S NEWMAN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3211
Practice Address - Country:US
Practice Address - Phone:201-489-9000
Practice Address - Fax:201-489-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7867603Medicaid
1192450001Medicare ID - Type Unspecified