| A1 Medical Care Pc | |
|
310 Central Ave Suite 310 East Orange NJ 07018-2835 | |
| (973) 678-2900 | |
| (973) 678-8183 |
| Full Name | A1 Medical Care Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 310 Central Ave, East Orange, New Jersey |
| Authorized Official Name and Position | Radhika Maddali (OWNER) |
| Authorized Official Contact | 9736782900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A1 Medical Care Pc 310 Central Ave Suite 310 East Orange NJ 07018-2835 Ph: (973) 678-2900 | A1 Medical Care Pc 310 Central Ave Suite 310 East Orange NJ 07018-2835 Ph: (973) 678-2900 |
| NPI Number | 1154662153 |
|---|---|
| Provider Enumeration Date | 03/15/2013 |
| Last Update Date | 03/15/2013 |
| Medicare PECOS PAC ID | 7911146097 |
|---|---|
| Medicare Enrollment ID | O20130621000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154662153 | NPI | - | NPPES |
| 0105481 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 25MA07474500 (New Jersey) | Primary |
| Provider Name | Radhika Maddali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790872638 PECOS PAC ID: 9537132519 Enrollment ID: I20040817001328 |
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