Sports Extra PC
Family Medicine, Sports Medicine in Clark, New Jersey
1346296969- Practice location
- 67 Walnut Ave, Suite 202, Clark, NJ 07066-1640
- Phone
- 732-388-7300
- Fax
- 732-388-1330
- Last updated
- October 18, 2007
Sports Extra PC is a healthcare organization based in Clark, NJ. Sports Extra PC practices in Clark, NJ. The NPI Number for Sports Extra PC is 1346296969. The current practice location address for Sports Extra PC is 67 Walnut Ave, Suite 202, Clark, NJ 07066-1640 and can be reached out via phone at 732-388-7300 and via fax at 732-388-1330.
Provider Profile Details
- NPI Number
- 1346296969
- Provider Name
- Sports Extra PC
- Provider Entity Type
- Organization
- Address
- 67 Walnut Ave, Suite 202, Clark, NJ 07066-1640
- Phone Number
- 732-388-7300
- Fax Number
- 732-388-1330
- Primary Taxonomy
- Family Medicine, Sports Medicine · 207QS0010X
- Organization Subpart
- No
- Authorized Official
- Michele Theresa Gilsenan, DO · Practice Owner · 732-388-7300
- Provider Enumeration Date
- May 25, 2006
- Last Update Date
- October 18, 2007
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 67 Walnut Ave
Suite 202
Clark, NJ 07066-1640 - City
- Clark
- State
- New Jersey
- Zip
- 07066-1640
- Phone Number
- 732-388-7300
- Fax Number
- 732-388-1330
Provider Business Mailing Address Details
- Address
- 67 Walnut Ave
Suite 202
Clark, NJ 07066-1640 - City
- Clark
- State
- NJ
- Zip
- 07066-1640
- Phone Number
- 732-388-7300
- Fax Number
- 732-388-1330
License Information
- Taxonomy
- Family Medicine, Sports Medicine · 207QS0010X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Family Medicine, Sports Medicine providers near Clark, NJ
View all Family Medicine, Sports Medicine providers in Clark →Frequently Asked Questions
What is the NPI number of Sports Extra PC?
The NPI number of Sports Extra PC is 1346296969. It was assigned on May 25, 2006 and is currently active in the NPPES registry.
What is the specialty of Sports Extra PC?
Sports Extra PC is registered under the primary taxonomy Family Medicine, Sports Medicine (code 207QS0010X).
Where does Sports Extra PC practice?
The practice location is 67 Walnut Ave, Suite 202, Clark, NJ 07066-1640. The office can be reached at 732-388-7300 (phone) or 732-388-1330 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1346296969 directly on the NPPES registry website.