| Cadoo Medical Pc | |
|
66 Park St Montclair NJ 07042-5908 | |
| (973) 577-3010 | |
| (973) 577-3011 |
| Full Name | Cadoo Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 66 Park St, Montclair, New Jersey |
| Authorized Official Name and Position | Lisa Cadoo (PRESIDENT) |
| Authorized Official Contact | 9735773010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cadoo Medical Pc 66 Park Street Suite 100 Montclair NJ 07042 Ph: (973) 577-3010 | Cadoo Medical Pc 66 Park St Montclair NJ 07042-5908 Ph: (973) 577-3010 |
| NPI Number | 1528626488 |
|---|---|
| Provider Enumeration Date | 06/04/2019 |
| Last Update Date | 11/13/2020 |
| Medicare PECOS PAC ID | 1052643830 |
|---|---|
| Medicare Enrollment ID | O20191028002589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528626488 | NPI | - | NPPES |
| 1538460498 | Other | NPI | |
| BCBS | Other | NJ | HORIZON |
| CIGNA | Other | NJ | CIGNA |
| CLOVER | Other | NJ | CLOVER |
| UHC | Other | NJ | UNITEDHEALTHCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lisa K Cadoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538460498 PECOS PAC ID: 1658528260 Enrollment ID: I20151103002982 |
| Provider Name | Sherri C Brown |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801464466 PECOS PAC ID: 3072917590 Enrollment ID: I20210805002354 |
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