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HEALTHSTAT ON-SITE CLINIC-PLYMOUTH ROCK MGT GROUP NPI 1164828695


NPI Information

NPI: 1164828695
Provider Name: HEALTHSTAT ON-SITE CLINIC-PLYMOUTH ROCK MGT GROUP
Classification: Preventive Medicine - 2083P0500X
Entity Type: Organization

Specialization: Preventive Medicine/Occupational Environmental Medicine

CLIA Number: 31D2086859

Address:
581 MAIN ST STE 304
WOODBRIDGE, NJ
ZIP 07095
Phone: (704) 529-6161
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HEALTHSTAT ON-SITE CLINIC-PLYMOUTH ROCK MGT GROUP is a preventive medicine/occupational environmental medicine preventive medicine in Woodbridge, NJ. The provider is a preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. HEALTHSTAT ON-SITE CLINIC-PLYMOUTH ROCK MGT GROUP NPI is 1164828695. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

581 MAIN ST STE 304
WOODBRIDGE, NJ
ZIP 07095-148
Phone: (704) 529-6161

The provider's authorized official is Warren Hutton .
The authorized official title is Coo and has the following contact phone number (704) 529-6161.

The CLIA number assigned to this NPI record is 31D2086859 - other - chronic mgt. clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/11/2014 and was last updated on 4/15/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12083P0500XPreventive MedicinePreventive Medicine/Occupational Environmental MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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