Provider Demographics
NPI:1720286024
Name:OCCUPATIONAL & COMMUNITY HEALTH SERVICES, INC
Entity type:Organization
Organization Name:OCCUPATIONAL & COMMUNITY HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:201-325-8002
Mailing Address - Street 1:3300 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-5976
Mailing Address - Country:US
Mailing Address - Phone:201-325-8002
Mailing Address - Fax:201-325-9718
Practice Address - Street 1:3300 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5976
Practice Address - Country:US
Practice Address - Phone:201-325-8002
Practice Address - Fax:201-325-9718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-07
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN92137363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ087372Medicare ID - Type Unspecified