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Organization
MI CASA ES SU CASA, INC.
Active
Organization
MI CASA ES SU CASA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO GINES M.D. (CEO)
(201) 652-8434
Entity
Organization
Contact information
Practice address
911 E 23RD ST, PATERSON, NJ 07513-1500
(973) 345-4300
(973) 345-8811
Mailing address
30 S MAPLE AVE, RIDGEWOOD, NJ 07450-4508
(201) 652-8434
(201) 652-0194
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
708110
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6799701
—
NJ
Enumeration date
02/12/2007
Last updated
08/22/2020
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