| Advanced Metabolic Medicine | |
|
42 S Maple Ave Ste A Ridgewood NJ 07450-4508 | |
| (201) 857-5882 | |
| (973) 215-2052 |
| Full Name | Advanced Metabolic Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 42 S Maple Ave, Ridgewood, New Jersey |
| Authorized Official Name and Position | Kevin A Hall (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 2018575882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Metabolic Medicine 42 S Maple Ave Ste A Ridgewood NJ 07450-4508 Ph: (201) 857-5882 | Advanced Metabolic Medicine 42 S Maple Ave Ste A Ridgewood NJ 07450-4508 Ph: (201) 857-5882 |
| NPI Number | 1306290655 |
|---|---|
| Provider Enumeration Date | 04/22/2016 |
| Last Update Date | 04/22/2016 |
| Medicare PECOS PAC ID | 4082900212 |
|---|---|
| Medicare Enrollment ID | O20160914000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306290655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 25MA09133000 (New Jersey) | Primary |
| Provider Name | Kevin Arthur Hall |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1467708271 PECOS PAC ID: 3971732538 Enrollment ID: I20140611001449 |
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