BRANCH MEDICAL CLINIC EARLE (NPI# 1477750990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477750990 |
| Entity Type | Organization |
| Organization Name | BRANCH MEDICAL CLINIC EARLE |
| Practice Address |
201 State Route 34 S Colts Neck NJ 07722-1902 |
| Practice Telephone | 7328662300 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2017-12-19 |
| Authorized Official Name | MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HEALTH CLINIC ANNAPOLIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| Street Address |
201 STATE ROUTE 34 S |
| City | COLTS NECK |
| State | NJ |
| Zip Code | 07722-1902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457467235 | Catherine Baird | Dental Hygienist | 201 State Route 34 S, Colts Neck, NJ 07722-1902 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407379191 | Elena Marie Kochanek | Psychologist | 415 Highway 34, Suite 116, Colts Neck, NJ 07722 | 2017-07-25 |
| 1356890057 | Lauren Punzone | Nurse Practitioner | 12 Country Club Ln, Colts Neck, NJ 07722 | 2016-09-23 |
| 1922440627 | Vimax LLC | Clinic/Center | 6 Cornwall St., Colts Neck, NJ 07722 | 2013-07-23 |
| 1689923914 | Patricia Sobal | Behavioral Analyst | 12 Mulberry Lane, Colts Neck, NJ 07722 | 2012-08-31 |
| 1538414776 | Marsha E Bodus | Registered Nurse | 201 Route 34 South, Bldg C-3, Colts Neck, NJ 07722 | 2012-07-13 |
| 1104116649 | Andrew Gerard Fischer | Dentist | 340 Route 34 South, Suite 204, Colts Neck, NJ 07722 | 2011-04-18 |
| 1891961744 | Gloria Yrizarry Tillmann | Psychologist | 14 Red Hawk Rd No, Colts Neck, NJ 07722 | 2008-05-01 |
| 1225214604 | Reflections @ Colts Neck | Assisted Living Facility | 3 Meridian Circle, Colts Neck, NJ 07722 | 2008-01-15 |
| 1255462552 | Judith Ann Kramer | Psychologist | 29 State Highway #34, Colts Neck, NJ 07722 | 2007-03-08 |
| 1164567467 | Harlene Joy Ross | Social Worker | 29 Highway 34, Colts Neck Consulting Group, Colts Neck, NJ 07722 | 2007-02-21 |
| Find all providers in zip 07722 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962660340 | United States Coast Guard, Air Station Atlantic City | Clinic/Center | Faa Tech Center Bldg 350, Uscg Medical Dept, Pomona, NJ 08405 | 2008-06-02 |
| 1952509812 | Branch Medical Clinic Lakehurst | Clinic/Center | Bldg 39 Landsdowne Road, Lakehurst, NJ 08733-5006 | 2007-07-03 |
| 1275747149 | Keller Army Community Hospital | Clinic/Center | 5631 Baltimore St, Fort Dix, NJ 08640-5440 | 2007-05-10 |
| 1912006685 | Keller Army Community Hospital | Clinic/Center | Bldg. 1075 Stephenson Ave., Ft. Monmouth, NJ 07703 | 2006-09-21 |
| 1528245271 | Uscg Clinic Cape May | Clinic/Center | 1 Munro Ave, Health Services Division, Cape May, NJ 08204-5000 | 2008-01-24 |
| 1124223235 | Keller Army Community Hospital | Clinic/Center | 5660 Doughboy Loop, Fort Dix, NJ 08640 | 2007-06-19 |
| 1205031770 | Keller Army Community Hospital | Clinic/Center | 1075 Stephenson Ave, Usadc, Fort Monmouth, NJ 07703-1518 | 2007-06-15 |
| 1972667228 | Uscg Samuel J Call Health Services | Clinic/Center | 1 Munro Ave, Cape May, NJ 08204-5000 | 2006-12-21 |
| City | COLTS NECK |
| Zip Code | 07722 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.