Organization
CARERIVET MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL WALTERS MD (OWNER/MD)
(845) 721-1848
Entity
Organization
Contact information
Practice address
26 UNIVERSITY PLACE BLVD, 1ST FLOOR, JERSEY CITY, NJ 07305
(845) 721-1848
Mailing address
26 UNIVERSITY PLACE BLVD, 1ST FLOOR, JERSEY CITY, NJ 07305
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA03794100
MEDICAL LICENSE
NJ
Enumeration date
02/25/2019
Last updated
02/25/2019
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