Provider Demographics
NPI:1528140563
Name:CARTERET COMPREHENSIVE MEDICAL CARE,PC
Entity type:Organization
Organization Name:CARTERET COMPREHENSIVE MEDICAL CARE,PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-662-9901
Mailing Address - Street 1:72 ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3986
Mailing Address - Country:US
Mailing Address - Phone:732-662-9901
Mailing Address - Fax:732-662-9904
Practice Address - Street 1:72 ROUTE 27
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3986
Practice Address - Country:US
Practice Address - Phone:732-662-9901
Practice Address - Fax:732-662-9904
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARTERET COMPREHENSIVE MEDICAL CARE, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-19
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDC3345OtherRAILROAD MEDICARE
NJ5343570001Medicare NSC
NJ083165Medicare PIN