| Garden State Geriatrics Llc | |
|
773 Teaneck Road Teaneck NJ 07666 | |
| (201) 530-5390 | |
| (201) 530-5391 |
| Full Name | Garden State Geriatrics Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 773 Teaneck Road, Teaneck, New Jersey |
| Authorized Official Name and Position | Kavitha Subramanian (PHYSICIAN) |
| Authorized Official Contact | 7324911093 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden State Geriatrics Llc 53 Heather Hill Rd Cresskill NJ 07626 Ph: (732) 491-1093 | Garden State Geriatrics Llc 773 Teaneck Road Teaneck NJ 07666 Ph: (201) 530-5390 |
| NPI Number | 1861719718 |
|---|---|
| Provider Enumeration Date | 04/30/2010 |
| Last Update Date | 05/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861719718 | NPI | - | NPPES |
| 0153982 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 25MA07857500 (New Jersey) | Primary |
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