| Edison Family Practice Pc | |
|
616 Grove Ave Edison NJ 08820-3212 | |
| (732) 548-6303 | |
| (732) 549-4676 |
| Full Name | Edison Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 616 Grove Ave, Edison, New Jersey |
| Authorized Official Name and Position | Maria S Flores Dieppa (OWNER) |
| Authorized Official Contact | 7325486303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edison Family Practice Pc 616 Grove Ave Edison NJ 08820-3212 Ph: (732) 548-6303 | Edison Family Practice Pc 616 Grove Ave Edison NJ 08820-3212 Ph: (732) 548-6303 |
| NPI Number | 1548546286 |
|---|---|
| Provider Enumeration Date | 10/26/2011 |
| Last Update Date | 01/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548546286 | NPI | - | NPPES |
| 25MAO4500700ANI | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MA45007 (New Jersey) | Primary |
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