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Organization

PRIMARY CARE PROVIDERS, LLC

Active
Find providers by NPI
Organization

PRIMARY CARE PROVIDERS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS CORINA M IANCULOVICI NP (CEO)
(732) 292-0100
Entity
Organization

Contact information

Practice address
2640 HWY 70, BLDG.5 SUITE 102B, MANASQUAN, NJ 08736
(732) 292-0100
(732) 292-0900
Mailing address
2640 HIGHWAY 70 BUILDING 6B, MANASQUAN, NJ 08736-2610
(732) 292-0100
(732) 292-0900

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—

Other

Enumeration date
10/08/2018
Last updated
11/07/2019
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