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Organization

CENTRASTATE MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH FAISTL M.D (MEDICAL PROGRAM DIRECTOR)
(732) 294-2540
Entity
Organization

Contact information

Practice address
1001 W MAIN ST, FREEHOLD, NJ 07728-2579
(732) 294-2540
Mailing address
20105 BAINBRIDGE WAY, FREEHOLD, NJ 07728-4866
(732) 513-2546

Taxonomy

Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary

Other

Enumeration date
05/22/2008
Last updated
05/22/2008
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