| Elensa Medical Ii, Llc | |
|
635 Broadway 2nd Floor Paterson NJ 07514-1992 | |
| (973) 977-8105 | |
| (973) 977-8106 |
| Full Name | Elensa Medical Ii, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 635 Broadway, Paterson, New Jersey |
| Authorized Official Name and Position | Benjamin Antonio Sabido (OWNER) |
| Authorized Official Contact | 9739778105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elensa Medical Ii, Llc 1085 Franklin Lakes Road Franklin Lakes NJ 07417-1131 Ph: (973) 977-8105 | Elensa Medical Ii, Llc 635 Broadway 2nd Floor Paterson NJ 07514-1992 Ph: (973) 977-8105 |
| NPI Number | 1427291780 |
|---|---|
| Provider Enumeration Date | 04/15/2009 |
| Last Update Date | 11/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427291780 | NPI | - | NPPES |
| 0203521 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 25MA07696900 (New Jersey) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 25MA07696900 (New Jersey) | Secondary |
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