Classic Healthcare Physicians PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MB07406800 Issued in NJ

Legal business name

CLASSIC HEALTHCARE PHYSICIANS PA

Practice address

18 Clover Hill Cir
Egg Harbor TWP, NJ 08234-7557

Phone

(609) 653-3100

Fax

(609) 653-3155

NPI assigned

Jan 19, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Christopher Bolich, D.O.

Title

Owner

Phone

(609) 653-3100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Christopher Bolich, D.O.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Camden, NJ
  • NPI 1861592347

  I20100222000525

  Same enrollment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1154652907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CLOVER HILL CIR",
            "city": "EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "082347557",
            "telephone_number": "609-653-3100",
            "fax_number": "609-653-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CLOVER HILL CIR",
            "city": "EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "082347557",
            "telephone_number": "609-653-3100",
            "fax_number": "609-653-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC HEALTHCARE PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-19",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "BOLICH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-653-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB07406800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110246172",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latoya Nicole Cantie
• John Catalano, APN
• Sandra Milena Chavez-Victoria, CPRS
• Augustine O. Chikezie, MD
• Courtney Chileen, LCSW
• Shaketa Clay
• Coastal Nursing Services, LLC
• Nicholas J Coia III
• Community Quest, Inc.
• Joseph Conte, L.C.S.W.

• Internal Medicine Physician in Egg Harbor TWP, NJ
• Providers in Egg Harbor TWP, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.