Organization
365 CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE SHVARTSMAN (COO)
(646) 251-8770
Entity
Organization
Contact information
Practice address
315 BROAD STREET, SUITE 2, NEWARK, NJ 07102
(646) 251-8770
Mailing address
315 BROAD STREET, SUITE 2, NEWARK, NJ 07102
(646) 251-8770
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QM1000X
Migrant Health Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
305S00000X
Point of Service
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31D2258712
CLIA
—
Enumeration date
07/21/2022
Last updated
07/21/2022
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