| A&s General Physician Llc | |
|
1137 Main Ave Clifton NJ 07011-2386 | |
| (973) 773-0303 | |
| (973) 773-0004 |
| Full Name | A&s General Physician Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1137 Main Ave, Clifton, New Jersey |
| Authorized Official Name and Position | Angel R De La Cruz (OWNER) |
| Authorized Official Contact | 9737730303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A&s General Physician Llc 1137 Main Ave Clifton NJ 07011-2386 Ph: (973) 773-0303 | A&s General Physician Llc 1137 Main Ave Clifton NJ 07011-2386 Ph: (973) 773-0303 |
| NPI Number | 1295086908 |
|---|---|
| Provider Enumeration Date | 09/21/2012 |
| Last Update Date | 01/12/2016 |
| Medicare PECOS PAC ID | 5092964544 |
|---|---|
| Medicare Enrollment ID | O20120927000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295086908 | NPI | - | NPPES |
| 0300161 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Angel R De La Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336444777 PECOS PAC ID: 5597936336 Enrollment ID: I20120927000567 |
| Provider Name | Liss E Speziale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992239487 PECOS PAC ID: 3375899933 Enrollment ID: I20180712000152 |
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