Provider Demographics
NPI:1740539618
Name:ULTIMED HEALTH CARE PC
Entity type:Organization
Organization Name:ULTIMED HEALTH CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSIMINTIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-873-7787
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-0304
Mailing Address - Country:US
Mailing Address - Phone:732-972-1267
Mailing Address - Fax:
Practice Address - Street 1:50 FRANKLIN LN STE 201
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-2774
Practice Address - Country:US
Practice Address - Phone:888-744-8584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty