# COASTAL MEDICAL CARE LLC

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

## Provider details

- **NPI number:** 1508602897
- **Authorized official:** JOLENE RENEE GANIEL NP-C (PARTNER)
- **Authorized official phone:** (609) 703-9596

## Contact information

- **Practice address:** 293 US STATE ROUTE 9, MARMORA, NJ 08223
- **Practice address phone:** (609) 265-1500
- **Mailing address:** 293 US STATE ROUTE 9, MARMORA, NJ 08223
- **Mailing address phone:** (609) 265-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/05/2024
- **Last updated:** 07/05/2024