Organization
PRIMARY CARE NETWORK AT RARITAN BAY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HAILPERIN (MANAGED CARE)
(201) 818-9118
Entity
Organization
Contact information
Practice address
466 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3647
(732) 324-5140
Mailing address
PO BOX 48277, NEWARK, NJ 07101-4800
(201) 818-9118
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA07867800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0707547
PEDS AETNA HMO GROUP #
NJ
01
—
2682252000
PEDS AMERIHEALTH GROUP #
NJ
01
—
7141058
PEDS AETNA PPO GROUP #
NJ
01
—
8219701
PEDS GHI PPO GROUP #
NJ
Enumeration date
06/28/2006
Last updated
04/20/2008
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