Provider Demographics
NPI:1124449038
Name:MEDICAL HOUSE CALLS OF NJ, LLC
Entity type:Organization
Organization Name:MEDICAL HOUSE CALLS OF NJ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AVRIL
Authorized Official - Middle Name:OTHLYN
Authorized Official - Last Name:NOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:609-585-2447
Mailing Address - Street 1:1374 WHITEHORSE HAMILTON SQUARE RD STE 304
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3701
Mailing Address - Country:US
Mailing Address - Phone:908-839-8169
Mailing Address - Fax:
Practice Address - Street 1:1374 WHITEHORSE HAM SQ RD #304
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690
Practice Address - Country:US
Practice Address - Phone:908-839-8169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00363500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty