Organization
COLLEGE RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP CHASIN (OWNER)
(310) 528-6370
Entity
Organization
Contact information
Practice address
104 BAYARD ST, NEW BRUNSWICK, NJ 08901-2389
(310) 528-6370
Mailing address
104 BAYARD ST, NEW BRUNSWICK, NJ 08901-2389
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
00038910
NJ
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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