Provider Demographics
NPI:1043075526
Name:VILLAGE PRIMARY CARE LLC
Entity type:Organization
Organization Name:VILLAGE PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MEIR
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-262-2255
Mailing Address - Street 1:260 CHAMBERS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-2809
Mailing Address - Country:US
Mailing Address - Phone:732-262-2255
Mailing Address - Fax:732-262-3332
Practice Address - Street 1:21 W CLARKE AVE STE 1410
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1857
Practice Address - Country:US
Practice Address - Phone:732-262-2255
Practice Address - Fax:732-262-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center