Provider Demographics
NPI:1932721065
Name:NJ MULTI SPECIALTY & ACUTE CARE LLC
Entity Type:Organization
Organization Name:NJ MULTI SPECIALTY & ACUTE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-376-6100
Mailing Address - Street 1:9 LAKE CREST DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-9659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 JOURNAL SQUARE PLZ STE 303
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-4004
Practice Address - Country:US
Practice Address - Phone:914-376-6100
Practice Address - Fax:914-470-5056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty