| Center For Adult Medicine And Preventive Care, Pc | |
|
916-922 Main Ave Suite 1a Passaic NJ 07055-8544 | |
| (973) 773-0334 | |
| (973) 773-0336 |
| Full Name | Center For Adult Medicine And Preventive Care, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 916-922 Main Ave, Passaic, New Jersey |
| Authorized Official Name and Position | Carlos Alberto Tejeda (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7187048983 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Adult Medicine And Preventive Care, Pc 916-922 Main Ave Suite 1a Passaic NJ 07055-8544 Ph: (973) 773-0334 | Center For Adult Medicine And Preventive Care, Pc 916-922 Main Ave Suite 1a Passaic NJ 07055-8544 Ph: (973) 773-0334 |
| NPI Number | 1073779658 |
|---|---|
| Provider Enumeration Date | 08/02/2008 |
| Last Update Date | 09/15/2016 |
| Medicare PECOS PAC ID | 3779641162 |
|---|---|
| Medicare Enrollment ID | O20081029000674 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073779658 | NPI | - | NPPES |
| 135720 | Other | NJ | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Carlos A Tejeda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851342703 PECOS PAC ID: 9830157627 Enrollment ID: I20081015000220 |
| Provider Name | Luz Maria Meneses |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518143403 PECOS PAC ID: 6507162021 Enrollment ID: I20170801000082 |
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