| Geriatrics And Internal Medicine Associates Of Northeast Llc | |
|
1 W Ridgewood Ave Suite 203 Paramus NJ 07652-2359 | |
| (347) 308-4561 | |
| Not Available |
| Full Name | Geriatrics And Internal Medicine Associates Of Northeast Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 W Ridgewood Ave, Paramus, New Jersey |
| Authorized Official Name and Position | Susanthi Gunadasa (OWNER) |
| Authorized Official Contact | 3473084561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatrics And Internal Medicine Associates Of Northeast Llc 1 W Ridgewood Ave Suite 203 Paramus NJ 07652-2359 Ph: (347) 308-4561 | Geriatrics And Internal Medicine Associates Of Northeast Llc 1 W Ridgewood Ave Suite 203 Paramus NJ 07652-2359 Ph: (347) 308-4561 |
| NPI Number | 1952769960 |
|---|---|
| Provider Enumeration Date | 02/04/2016 |
| Last Update Date | 02/04/2016 |
| Medicare PECOS PAC ID | 8820393366 |
|---|---|
| Medicare Enrollment ID | O20160222002312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952769960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| Provider Name | Susanthi Gunadasa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639331861 PECOS PAC ID: 0143467456 Enrollment ID: I20131101001530 |
| Provider Name | Liliya Serada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104384619 PECOS PAC ID: 0143693986 Enrollment ID: I20240228001513 |
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