Provider Demographics
NPI:1962602912
Name:SARAHCARE@WATCHUNG SQUARE
Entity type:Organization
Organization Name:SARAHCARE@WATCHUNG SQUARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:GRANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-591-3882
Mailing Address - Street 1:35 MARY ELLEN DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1108
Mailing Address - Country:US
Mailing Address - Phone:908-591-3882
Mailing Address - Fax:908-222-8430
Practice Address - Street 1:130 ROUTE 22 E
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3806
Practice Address - Country:US
Practice Address - Phone:908-561-8888
Practice Address - Fax:908-561-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care