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Organization
REGIONAL CANCER CARE ASSOCIATES LLC
Active
Organization
REGIONAL CANCER CARE ASSOCIATES LLC
Active
Other names
Northern New Jersey Cancer Associates
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J LICITRA MD, PHD (CHAIRMAN)
(732) 390-7750
Entity
Organization
Contact information
Practice address
34-36 PROGRESS ST, SUITE B-2, EDISON, NJ 08820-1197
(908) 757-9696
(908) 757-9721
Mailing address
J2 BRIER HILL CT, EAST BRUNSWICK, NJ 08816-3340
(732) 390-7750
(732) 254-1048
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6682390022
MEDICARE NSC DMERC#
NJ
Enumeration date
08/02/2016
Last updated
12/12/2016
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