Ethos Primary Care Pc | |
177 W Mill Rd Long Valley NJ 07853-3439 | |
(908) 867-0060 | |
(908) 867-0059 |
Full Name | Ethos Primary Care Pc |
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Speciality | Internal Medicine |
Location | 177 W Mill Rd, Long Valley, New Jersey |
Authorized Official Name and Position | Ronald Weiss (PRESIDENT) |
Authorized Official Contact | 9088670060 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ethos Primary Care Pc 177 W Mill Rd Long Valley NJ 07853-3439 Ph: (908) 867-0060 | Ethos Primary Care Pc 177 W Mill Rd Long Valley NJ 07853-3439 Ph: (908) 867-0060 |
NPI Number | 1912396466 |
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Provider Enumeration Date | 01/21/2015 |
Last Update Date | 01/21/2015 |
Medicare PECOS PAC ID | 2668428731 |
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Medicare Enrollment ID | O20050323000042 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912396466 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Ronald Weiss |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1215047386 PECOS PAC ID: 4183699556 Enrollment ID: I20040830000350 |
Provider Name | Denise Bitz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730807686 PECOS PAC ID: 9436527520 Enrollment ID: I20221121002643 |
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