| Essex Plaza Medical Associates Pa | |
|
1060 Broad St Newark NJ 07102-2397 | |
| (973) 642-0280 | |
| (973) 642-0047 |
| Full Name | Essex Plaza Medical Associates Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1060 Broad St, Newark, New Jersey |
| Authorized Official Name and Position | Sandhya R Shah (PRESIDENT) |
| Authorized Official Contact | 9736420280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essex Plaza Medical Associates Pa 95 Falcon Rd Livingston NJ 07039-4427 Ph: (973) 642-0280 | Essex Plaza Medical Associates Pa 1060 Broad St Newark NJ 07102-2397 Ph: (973) 642-0280 |
| NPI Number | 1740475854 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 06/12/2013 |
| Medicare PECOS PAC ID | 6204874837 |
|---|---|
| Medicare Enrollment ID | O20050422000826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740475854 | NPI | - | NPPES |
| 1148001 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA45456 (New Jersey) | Primary |
| Provider Name | Sandhya Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770513376 PECOS PAC ID: 8921046558 Enrollment ID: I20050427000039 |
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