| Parkside Medical Center | |
|
75 Harrison Avenue Jersey City NJ 07304-0070 | |
| (201) 451-5425 | |
| (201) 451-7499 |
| Full Name | Parkside Medical Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 75 Harrison Avenue, Jersey City, New Jersey |
| Authorized Official Name and Position | Larry M Blake (CEO) |
| Authorized Official Contact | 2014515425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkside Medical Center P.o. Box 4070 75 Harrison Avenue Jersey City NJ 07304-0070 Ph: (201) 451-5425 | Parkside Medical Center 75 Harrison Avenue Jersey City NJ 07304-0070 Ph: (201) 451-5425 |
| NPI Number | 1336350909 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 10/06/2023 |
| Certification Date | 10/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336350909 | NPI | - | NPPES |
| 7734301 | Medicaid | NJ | |
| 6103201 | Medicaid | NJ | |
| 7864108 | Medicaid | NJ |
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