Provider Demographics
NPI:1700150786
Name:REGIONAL CANCER CARE ASSOCIATES
Entity Type:Organization
Organization Name:REGIONAL CANCER CARE ASSOCIATES
Other - Org Name:NORTHERN NEW JERSEY CANCER ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:NAHUM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-367-1535
Mailing Address - Street 1:25 MAIN ST STE 601
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7083
Mailing Address - Country:US
Mailing Address - Phone:201-510-0910
Mailing Address - Fax:732-367-9514
Practice Address - Street 1:57 KENT RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2452
Practice Address - Country:US
Practice Address - Phone:732-367-1535
Practice Address - Fax:732-367-9514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6682390008Medicare NSC