# CORNWALL POLYCLINIC, L.L.C.

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

## Provider details

- **NPI number:** 1568614253
- **Authorized official:** DR. BENJAMIN LEVINE M.D. (MANAGER)
- **Authorized official phone:** (732) 698-0700

## Contact information

- **Practice address:** 3 CORNWALL DR, EAST BRUNSWICK, NJ 08816-3311
- **Practice address phone:** (732) 698-0700
- **Mailing address:** 3 CORNWALL DR, EAST BRUNSWICK, NJ 08816-3311
- **Mailing address phone:** (732) 698-0700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | MA023897 | NJ | Yes |

## Other

- **Enumeration date:** 10/14/2008
- **Last updated:** 10/14/2008