| Regis F Acosta Md Llc | |
|
104 Independence Blvd Sicklerville NJ 08081-1039 | |
| (856) 885-4529 | |
| Not Available |
| Full Name | Regis F Acosta Md Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 104 Independence Blvd, Sicklerville, New Jersey |
| Authorized Official Name and Position | Regis F Acosta (OWNER) |
| Authorized Official Contact | 8568854529 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regis F Acosta Md Llc 104 Independence Blvd Sicklerville NJ 08081-1039 Ph: (856) 885-4529 | Regis F Acosta Md Llc 104 Independence Blvd Sicklerville NJ 08081-1039 Ph: (856) 885-4529 |
| NPI Number | 1427364488 |
|---|---|
| Provider Enumeration Date | 08/27/2010 |
| Last Update Date | 09/23/2010 |
| Medicare PECOS PAC ID | 2961696364 |
|---|---|
| Medicare Enrollment ID | O20101029000872 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427364488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 25MA0732300 (New Jersey) | Primary |
| Provider Name | Regis F Acosta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366523011 PECOS PAC ID: 7113113598 Enrollment ID: I20101124000484 |
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