Organization
MI CASA ES SU CASA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO GINES M.D. (CEO)
(201) 652-8434
Entity
Organization
Contact information
Practice address
911 E 23RD ST, PATERSON, NJ 07513-1500
(973) 345-4300
(973) 345-8811
Mailing address
30 S MAPLE AVE, RIDGEWOOD, NJ 07450-4508
(201) 652-8434
(201) 652-0194
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
708110
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6799701
—
NJ
Enumeration date
02/12/2007
Last updated
08/22/2020
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