| Garden State Family Care | |
|
511 S Orange Ave South Orange NJ 07079-2636 | |
| (973) 821-3640 | |
| (973) 821-3651 |
| Full Name | Garden State Family Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 511 S Orange Ave, South Orange, New Jersey |
| Authorized Official Name and Position | Tatiana Mouravskaia (MEMBER) |
| Authorized Official Contact | 9738213640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden State Family Care 511 S Orange Ave South Orange NJ 07079-2636 Ph: (973) 821-3640 | Garden State Family Care 511 S Orange Ave South Orange NJ 07079-2636 Ph: (973) 821-3640 |
| NPI Number | 1235317967 |
|---|---|
| Provider Enumeration Date | 02/05/2008 |
| Last Update Date | 02/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235317967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (New Jersey) | Primary |
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