Cornwall Polyclinic, L.L.C.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

MA023897 Issued in NJ

Legal business name

CORNWALL POLYCLINIC, L.L.C.

Practice address

3 Cornwall Dr
East Brunswick, NJ 08816-3311

Phone

(732) 698-0700

NPI assigned

Oct 14, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Levine, M.D.

Title

Manager

Phone

(732) 698-0700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1568614253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CORNWALL DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163311",
            "telephone_number": "732-698-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CORNWALL DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163311",
            "telephone_number": "732-698-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNWALL POLYCLINIC, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-698-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NJ",
            "license": "MA023897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urgent Care Clinic/Center in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Urgent Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.