Organization
CLINTON AVENUE COMMUNITY CARE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUZ CAPCHA (CHIEF REVENUE OFFICER & VBC)
(973) 672-2455
Entity
Organization
Contact information
Practice address
1577 ROUTE 517, HACKETTSTOWN, NJ 07840-2708
(973) 672-8573
Mailing address
613 PARK AVE, EAST ORANGE, NJ 07017-1905
(973) 672-2455
(973) 675-0040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/19/2025
Last updated
04/19/2025
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