Provider Demographics
NPI:1366510851
Name:CAPITAL HEALTH SYSTEMS
Entity type:Organization
Organization Name:CAPITAL HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-528-8888
Mailing Address - Street 1:1401 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:INSTIUTE FOR NEUROSCIENCE
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3817
Mailing Address - Country:US
Mailing Address - Phone:609-528-8888
Mailing Address - Fax:609-584-5151
Practice Address - Street 1:1401 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:INSTIUTE FOR NEUROSCIENCE
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-3817
Practice Address - Country:US
Practice Address - Phone:609-528-8888
Practice Address - Fax:609-584-5151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA50235174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD19308Medicare UPIN