Provider Demographics
NPI:1912140229
Name:BC MEDICAL CARE LLC
Entity type:Organization
Organization Name:BC MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CAUVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-864-6833
Mailing Address - Street 1:1747 HOOPER AVE
Mailing Address - Street 2:UNIT 8
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8165
Mailing Address - Country:US
Mailing Address - Phone:732-255-6777
Mailing Address - Fax:732-255-6669
Practice Address - Street 1:1747 HOOPER AVE
Practice Address - Street 2:UNIT 8
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8165
Practice Address - Country:US
Practice Address - Phone:732-255-6777
Practice Address - Fax:732-255-6669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB066721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty