| Ennoble HC Ky PLLC | |
|
2 University Plz Ste 204 Hackensack NJ 07601-6211 | |
| (551) 295-8223 | |
| Not Available |
| Full Name | Ennoble HC Ky PLLC |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 2 University Plz Ste 204, Hackensack, New Jersey |
| Authorized Official Name and Position | Mark Bradshaw (OWNER) |
| Authorized Official Contact | 6786652618 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ennoble HC Ky PLLC 2 University Plz Hackensack NJ 07601-6202 Ph: (551) 295-8223 | Ennoble HC Ky PLLC 2 University Plz Ste 204 Hackensack NJ 07601-6211 Ph: (551) 295-8223 |
| NPI Number | 1275469488 |
|---|---|
| Provider Enumeration Date | 06/23/2026 |
| Last Update Date | 06/23/2026 |
| Certification Date | 06/23/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275469488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | () | Primary |
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