# CARBON HEALTH MEDICAL GROUP OF NEW JERSEY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134888688
- **Authorized official:** KAILTIN BOYLE (DIRECTOR)
- **Authorized official phone:** (303) 601-5392

## Contact information

- **Practice address:** 1603 W LANE AVE \# C168, COLUMBUS, OH 43221-3924
- **Practice address phone:** (614) 647-9646
- **Practice address fax:** (888) 972-1912
- **Mailing address:** 2100 FRANKLIN ST STE 355, OAKLAND, CA 94612-3140
- **Mailing address phone:** (415) 446-1733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/13/2021
- **Last updated:** 07/16/2024