Organization
UNITY PLACE OF ATLANTIC COUNTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY TISCHLER (AUTHORIZED OFFICIAL)
(347) 242-6502
Entity
Organization
Contact information
Practice address
121 S WHITE HORSE PIKE, HAMMONTON, NJ 08037-1871
(609) 704-1313
Mailing address
821 WOODLAND DR, LAKEWOOD, NJ 08701-3038
(347) 242-6502
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0461938
—
NJ
Enumeration date
09/29/2017
Last updated
09/29/2017
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