Provider Demographics
NPI:1932473576
Name:SHORE PHYSICIANS FOR ALTERNATIVE MEDICINE PC
Entity Type:Organization
Organization Name:SHORE PHYSICIANS FOR ALTERNATIVE MEDICINE PC
Other - Org Name:PHYSICIAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGEMENT COMPANY
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:J
Authorized Official - Last Name:SALANI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:732-542-2638
Mailing Address - Street 1:107 MONMOUTH RD
Mailing Address - Street 2:STE 104
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1000
Mailing Address - Country:US
Mailing Address - Phone:732-542-2638
Mailing Address - Fax:732-542-2620
Practice Address - Street 1:107 MONMOUTH RD
Practice Address - Street 2:STE 104
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1000
Practice Address - Country:US
Practice Address - Phone:732-542-2638
Practice Address - Fax:732-542-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service