Provider Demographics
NPI:1750563763
Name:CARE BY YOUR SIDE
Entity type:Organization
Organization Name:CARE BY YOUR SIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRONGONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-784-4047
Mailing Address - Street 1:123 SPUTH WHITE HORSE PIKE
Mailing Address - Street 2:UNIT C
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-1757
Mailing Address - Country:US
Mailing Address - Phone:856-784-4047
Mailing Address - Fax:856-784-4049
Practice Address - Street 1:123 SOUTH WHITE HORSE PIKE
Practice Address - Street 2:UNIT C
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-1757
Practice Address - Country:US
Practice Address - Phone:856-784-4047
Practice Address - Fax:856-784-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0101900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health