Provider Demographics
NPI:1801963962
Name:MEDICAL CARE CENTER, P.C.
Entity type:Organization
Organization Name:MEDICAL CARE CENTER, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIENTEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-388-4787
Mailing Address - Street 1:1082 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2664
Mailing Address - Country:US
Mailing Address - Phone:732-388-4344
Mailing Address - Fax:
Practice Address - Street 1:1082 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2664
Practice Address - Country:US
Practice Address - Phone:732-388-4344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00465300111N00000X
NJ25MA06835600174400000X
NJ40QA00922600225100000X
NJ38MC2736111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6050410001Medicare NSC