Provider Demographics
NPI:1689852907
Name:BETHEL HEALTH CARE LLC
Entity type:Organization
Organization Name:BETHEL HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PREETHI
Authorized Official - Middle Name:SARA
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-837-2500
Mailing Address - Street 1:765 TEANECK RD
Mailing Address - Street 2:SUITE 1 R
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4248
Mailing Address - Country:US
Mailing Address - Phone:201-837-2500
Mailing Address - Fax:201-837-2511
Practice Address - Street 1:765 TEANECK RD
Practice Address - Street 2:SUITE 1 R
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4248
Practice Address - Country:US
Practice Address - Phone:201-837-2500
Practice Address - Fax:201-837-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07941700261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care