Organization
REGIONAL CANCER CARE ASSOCIATES LLC
Active
Other names
Northern New Jersey Cancer Associates
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J LICITRA MD, PHD (CHAIRMAN)
(732) 390-7750
Entity
Organization
Contact information
Practice address
34-36 PROGRESS ST, SUITE B-2, EDISON, NJ 08820-1197
(908) 757-9696
(908) 757-9721
Mailing address
J2 BRIER HILL CT, EAST BRUNSWICK, NJ 08816-3340
(732) 390-7750
(732) 254-1048
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6682390022
MEDICARE NSC DMERC#
NJ
Enumeration date
08/02/2016
Last updated
12/12/2016
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