| Destyoncall Healthcare | |
|
321 Yale Ave Suite D Stratford NJ 08084-1247 | |
| (856) 627-6101 | |
| (856) 627-6103 |
| Full Name | Destyoncall Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 321 Yale Ave, Stratford, New Jersey |
| Authorized Official Name and Position | Gerda Augustin (PEDIATRICIAN) |
| Authorized Official Contact | 8566276101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Destyoncall Healthcare 321 Yale Ave Suite D Stratford NJ 08084-1247 Ph: (856) 627-6101 | Destyoncall Healthcare 321 Yale Ave Suite D Stratford NJ 08084-1247 Ph: (856) 627-6101 |
| NPI Number | 1073749222 |
|---|---|
| Provider Enumeration Date | 06/02/2009 |
| Last Update Date | 06/02/2009 |
| Medicare PECOS PAC ID | 3476960360 |
|---|---|
| Medicare Enrollment ID | O20210319001368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073749222 | NPI | - | NPPES |
| 0063002 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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