Provider Demographics
NPI:1619361839
Name:RJH MEDICAL LLC
Entity type:Organization
Organization Name:RJH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HERBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-664-0372
Mailing Address - Street 1:1608 BAY AVE
Mailing Address - Street 2:2ND FL
Mailing Address - City:BAY HEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4558
Mailing Address - Country:US
Mailing Address - Phone:732-664-0372
Mailing Address - Fax:732-748-0800
Practice Address - Street 1:1608 BAY AVE
Practice Address - Street 2:2ND FL
Practice Address - City:BAY HEAD
Practice Address - State:NJ
Practice Address - Zip Code:08742-4558
Practice Address - Country:US
Practice Address - Phone:732-664-0372
Practice Address - Fax:732-748-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00390300261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1851699342Medicare UPIN