| |
61 W Jimmie Leeds Road Pomona NJ 08240-0723 | |
(609) 652-7000 | |
(609) 748-7755 |
Full Name | |
---|---|
Speciality | Rehabilitation Practitioner |
Location | 61 W Jimmie Leeds Road, Pomona, New Jersey |
Authorized Official Name and Position | Nancy F. Price (DIRECTOR PATIENT FINANCIAL SERVICES) |
Authorized Official Contact | 6097485454 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
61 W Jimmie Leeds Road Pomona NJ 08240-0723 Ph: (609) 652-7000 | 61 W Jimmie Leeds Road Pomona NJ 08240-0723 Ph: (609) 652-7000 |
NPI Number | 1922171560 |
---|---|
Provider Enumeration Date | 11/15/2006 |
Last Update Date | 11/02/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922171560 | NPI | - | NPPES |
7070004 | Medicaid | NJ | |
665930 | Other | NJ | MEDICARE ID-TYPE UNSPECIFIED |
CB9450 | Other | NJ | MEDICARE B RAILROAD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (New Jersey) | Secondary |
225400000X | Rehabilitation Practitioner | (New Jersey) | Primary |
363L00000X | Nurse Practitioner | (New Jersey) | Secondary |