Provider Demographics
NPI:1306054820
Name:CARE STATIONS
Entity type:Organization
Organization Name:CARE STATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BEZOZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-925-7519
Mailing Address - Street 1:3 SQUIRE CT
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2506
Mailing Address - Country:US
Mailing Address - Phone:973-533-0577
Mailing Address - Fax:973-994-9107
Practice Address - Street 1:328 W. ST. GEORGES AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036
Practice Address - Country:US
Practice Address - Phone:973-533-0577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02738300261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG91222Medicare UPIN
NJ026484Medicare ID - Type Unspecified