| Bergen Medical Care Pc | |
|
110 Broad Ave Ste 7 Palisades Park NJ 07650-2722 | |
| (718) 887-4858 | |
| Not Available |
| Full Name | Bergen Medical Care Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 110 Broad Ave Ste 7, Palisades Park, New Jersey |
| Authorized Official Name and Position | Daniel D Park (OWNER) |
| Authorized Official Contact | 7188874858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Medical Care Pc 110 Broad Ave Ste 7 Palisades Park NJ 07650-2722 Ph: () - | Bergen Medical Care Pc 110 Broad Ave Ste 7 Palisades Park NJ 07650-2722 Ph: (718) 887-4858 |
| NPI Number | 1396484416 |
|---|---|
| Provider Enumeration Date | 05/27/2022 |
| Last Update Date | 05/27/2022 |
| Medicare PECOS PAC ID | 0648652651 |
|---|---|
| Medicare Enrollment ID | O20220806000703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396484416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel D Park |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831239391 PECOS PAC ID: 3173781374 Enrollment ID: I20220806000695 |
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