Basic Information
| Provider Information | |||||||||
| NPI: | 1942437124 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CLINICAL HEALTH CARE ASSOCIATES OF NEW JERSEY, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 409 ROUTE 70 E | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080342413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007897366 | ||||||||
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| Address1: | 409 ROUTE 70 E | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080342413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007897366 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2009 | ||||||||
| LastUpdateDate: | 06/16/2009 | ||||||||
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| AuthorizedOfficialLastName: | BARG | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6109021720 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.