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Organization
SPORTSCARE OF AMERICA, PC
Active
Organization
SPORTSCARE OF AMERICA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH ALTAGRACIA LANTIGUA (CONTRACT MANAGER)
(973) 887-9000
Entity
Organization
Contact information
Practice address
11 EAGLE ROCK AVE, SUITE 103, EAST HANOVER, NJ 07936-3167
(973) 887-0115
(973) 887-0775
Mailing address
11 EAGLE ROCK AVE, 2ND FLOOR, EAST HANOVER, NJ 07936-3167
(973) 887-9000
(973) 887-3816
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00609800
NJ
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF647
RAILROAD MEDICARE
NJ
Enumeration date
10/02/2006
Last updated
01/16/2019
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