Organization
IMPERIAL SUPPORT COORDINATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL KUKUBOR (PRESIDENT)
(347) 595-3597
Entity
Organization
Contact information
Practice address
183 JOHNSTON DR, WATCHUNG, NJ 07069-4927
(347) 595-3597
Mailing address
183 JOHNSTON DR, WATCHUNG, NJ 07069-4927
(347) 595-3597
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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