Organization
PERTH AMBOY HEALTH CARE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULETTE CLAY (CHIEF EXECUTIVE OFFICER)
(732) 442-5444
Entity
Organization
Contact information
Practice address
607 AMBOY AVENUE, PERTH AMBOY, NJ 08861-2595
(732) 442-5444
(732) 442-2626
Mailing address
607 AMBOY AVENUE, PERTH AMBOY, NJ 08861-2595
(732) 442-5444
(732) 442-2626
Taxonomy
Speciality
Code
Description
License number
State
261QR0206X
Mammography Clinic/Center
Primary
22620
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8180202
—
NJ
Enumeration date
06/16/2006
Last updated
09/18/2019
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