Provider Demographics
NPI:1386619997
Name:COMPREHENSIVE ENDOCRINE CARE DIABETES HORMONES AND METABOLISM
Entity type:Organization
Organization Name:COMPREHENSIVE ENDOCRINE CARE DIABETES HORMONES AND METABOLISM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-868-0001
Mailing Address - Street 1:PO BOX 448
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-0448
Mailing Address - Country:US
Mailing Address - Phone:201-868-0001
Mailing Address - Fax:201-868-0999
Practice Address - Street 1:7800 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5527
Practice Address - Country:US
Practice Address - Phone:201-868-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA75436207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty