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Organization

OPTUM MEDICAL CARE OF NEW JERSEY PC

Active
Other names
Riverside pediatric group
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GAURANG BRAHMBHATT M.D. (CMO)
(201) 636-7233
Entity
Organization

Contact information

Practice address
1 HARMON PLZ FL 10, SECAUCUS, NJ 07094-2803
(201) 636-7233
(201) 552-2358
Mailing address
1 HARMON PLZ FL 10, SECAUCUS, NJ 07094-2803
(201) 636-7233
(201) 552-2358

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08407900
NJ
208000000X
Pediatrics Physician
Primary
25MA03363500
NJ
332B00000X
Durable Medical Equipment & Medical Supplies
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9088008
NJ
Enumeration date
09/03/2006
Last updated
09/14/2022
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