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Organization
DIGITRACE CARE SERVICES INC
Active
Organization
DIGITRACE CARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL R. IBERGER (EVP/CFO)
(978) 536-7400
Entity
Organization
Contact information
Practice address
401 S VAN BRUNT ST, 4TH FLOOR, ENGLEWOOD, NJ 07631-4604
(610) 543-6800
(610) 543-8051
Mailing address
200 CORPORATE PL, SUITE 5B, PEABODY, MA 01960-3840
(978) 536-7400
(978) 535-9757
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0453320000
AMERIHEALTH PERS CHOICE
NJ
01
—
0658107000
AMERIHEALTH HMO
NJ
01
—
7618325
AETNA
NJ
Enumeration date
08/09/2006
Last updated
11/23/2011
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