Provider Demographics
NPI:1396270716
Name:ADULT & GERIATRIC CARE LLC
Entity type:Organization
Organization Name:ADULT & GERIATRIC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, APN
Authorized Official - Phone:732-255-2252
Mailing Address - Street 1:1 W CHAUCER LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07727-4344
Mailing Address - Country:US
Mailing Address - Phone:732-255-2252
Mailing Address - Fax:848-444-8001
Practice Address - Street 1:1 W CHAUCER LN
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NJ
Practice Address - Zip Code:07727-4344
Practice Address - Country:US
Practice Address - Phone:732-255-2252
Practice Address - Fax:848-444-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-23
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty