Organization Name: | CONNECTED CARE LIMITED LIABILITY |
NPI Number: | 1033473939 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEEANNA ROMAN (SOLE OWNER) |
Mailing Address: | 411 Commerce Ln West Berlin |
State: | NJ US |
Postal Code: | 080919254 |
Phone Number: | 8567537763 |
Fax Number: | 8567537714 |
NPI Enumeration Date: | 06/26/2012 |
NPI Last Update Date: | 06/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |