| C. Dicovsky Medical Group, Llc | |
|
681 Broadway Paterson NJ 07514-1421 | |
| (973) 278-1000 | |
| (973) 278-1709 |
| Full Name | C. Dicovsky Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 681 Broadway, Paterson, New Jersey |
| Authorized Official Name and Position | Teresa Lares (MANAGER) |
| Authorized Official Contact | 9732781000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C. Dicovsky Medical Group, Llc 681 Broadway Paterson NJ 07514-1421 Ph: (973) 278-1000 | C. Dicovsky Medical Group, Llc 681 Broadway Paterson NJ 07514-1421 Ph: (973) 278-1000 |
| NPI Number | 1821097940 |
|---|---|
| Provider Enumeration Date | 07/20/2005 |
| Last Update Date | 03/10/2022 |
| Medicare PECOS PAC ID | 9537347737 |
|---|---|
| Medicare Enrollment ID | O20110616000479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821097940 | NPI | - | NPPES |
| Provider Name | Marcela C Marani-dicovskiy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386727287 PECOS PAC ID: 8123063104 Enrollment ID: I20050621000338 |
| Provider Name | Safwan Sweidan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578644860 PECOS PAC ID: 2860685179 Enrollment ID: I20101019001283 |
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