| Delran Internal Medicine Llc | |
|
5045 Rte 130 S Ste E Delran NJ 08075-9707 | |
| (856) 764-2525 | |
| (856) 764-6344 |
| Full Name | Delran Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5045 Rte 130 S, Delran, New Jersey |
| Authorized Official Name and Position | Matthew P Basara (PHYSICIAN) |
| Authorized Official Contact | 8567642525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delran Internal Medicine Llc 5045 Rte 130 S Ste E Delran NJ 08075-9707 Ph: (856) 764-2525 | Delran Internal Medicine Llc 5045 Rte 130 S Ste E Delran NJ 08075-9707 Ph: (856) 764-2525 |
| NPI Number | 1356499768 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 12/18/2009 |
| Medicare PECOS PAC ID | 7911952056 |
|---|---|
| Medicare Enrollment ID | O20050322000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356499768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA57034 (New Jersey) | Primary |
| Provider Name | Matthew P Basara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972602191 PECOS PAC ID: 3779528302 Enrollment ID: I20050624000034 |
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