| Dedicated Primary Care Llc | |
|
239 Claremont Ave Montclair NJ 07042-2833 | |
| (973) 771-3863 | |
| Not Available |
| Full Name | Dedicated Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 239 Claremont Ave, Montclair, New Jersey |
| Authorized Official Name and Position | Tianzhong Yang (PRIMARY CARE PHYSICIAN) |
| Authorized Official Contact | 9737713863 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dedicated Primary Care Llc 4 Crystal Ct Apt B2 Woodland Park NJ 07424-4261 Ph: () - | Dedicated Primary Care Llc 239 Claremont Ave Montclair NJ 07042-2833 Ph: (973) 771-3863 |
| NPI Number | 1497180541 |
|---|---|
| Provider Enumeration Date | 09/09/2013 |
| Last Update Date | 09/09/2013 |
| Medicare PECOS PAC ID | 3173759966 |
|---|---|
| Medicare Enrollment ID | O20131127000794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497180541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 25MA09295600 (New Jersey) | Primary |
| Provider Name | Tianzhong Yang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255521753 PECOS PAC ID: 4082840871 Enrollment ID: I20131127000834 |
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