Provider Demographics
NPI:1700623246
Name:CENTER FOR GERIATRIC CARE AND WELLNESS
Entity type:Organization
Organization Name:CENTER FOR GERIATRIC CARE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:GLANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-703-6622
Mailing Address - Street 1:860 VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-6145
Mailing Address - Country:US
Mailing Address - Phone:845-494-8474
Mailing Address - Fax:732-722-1024
Practice Address - Street 1:860 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-6145
Practice Address - Country:US
Practice Address - Phone:732-703-6622
Practice Address - Fax:732-722-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty