Provider Demographics
NPI:1447676382
Name:TRAVEL MEDICINE OF NEW JERSEY
Entity type:Organization
Organization Name:TRAVEL MEDICINE OF NEW JERSEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CLINICAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:732-345-0029
Mailing Address - Street 1:655 SHREWSBURY AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4179
Mailing Address - Country:US
Mailing Address - Phone:732-345-0029
Mailing Address - Fax:732-345-0037
Practice Address - Street 1:655 SHREWSBURY AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4179
Practice Address - Country:US
Practice Address - Phone:732-345-0029
Practice Address - Fax:732-345-0037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty