| Advanced General Medicine | |
|
1019 E Jersey St Elizabeth NJ 07201-5503 | |
| (929) 279-3379 | |
| Not Available |
| Full Name | Advanced General Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 1019 E Jersey St, Elizabeth, New Jersey |
| Authorized Official Name and Position | Raul E Vasquez Duran (OWNER) |
| Authorized Official Contact | 9084406395 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced General Medicine 1019 E Jersey St Elizabeth NJ 07201-5503 Ph: () - | Advanced General Medicine 1019 E Jersey St Elizabeth NJ 07201-5503 Ph: (929) 279-3379 |
| NPI Number | 1609524941 |
|---|---|
| Provider Enumeration Date | 03/15/2022 |
| Last Update Date | 06/29/2022 |
| Medicare PECOS PAC ID | 7517344591 |
|---|---|
| Medicare Enrollment ID | O20220512001101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609524941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Raul E Vasquez Duran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366971244 PECOS PAC ID: 4385063494 Enrollment ID: I20200923000864 |
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