| Harrison Medical Group Llc | |
|
332 Harrison Ave Harrison NJ 07029-1775 | |
| (973) 484-9216 | |
| (973) 484-9216 |
| Full Name | Harrison Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 332 Harrison Ave, Harrison, New Jersey |
| Authorized Official Name and Position | Ray Ryan Santos (MEDICAL DOCTOR) |
| Authorized Official Contact | 9734842584 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harrison Medical Group Llc 332 Harrison Ave Harrison NJ 07029-1775 Ph: (973) 484-9216 | Harrison Medical Group Llc 332 Harrison Ave Harrison NJ 07029-1775 Ph: (973) 484-9216 |
| NPI Number | 1841579851 |
|---|---|
| Provider Enumeration Date | 08/08/2011 |
| Last Update Date | 03/29/2012 |
| Medicare PECOS PAC ID | 8123288123 |
|---|---|
| Medicare Enrollment ID | O20120329000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841579851 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA08446200 (New Jersey) | Primary |
| 208000000X | Pediatrics | 25MA08446200 (New Jersey) | Secondary |
| Provider Name | Catalino L Dela Cruz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124131016 PECOS PAC ID: 7012981657 Enrollment ID: I20050315000102 |
| Provider Name | Joseph G Anton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396831814 PECOS PAC ID: 5698722528 Enrollment ID: I20050404000387 |
| Provider Name | Viju Vijaysadan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538110754 PECOS PAC ID: 8022029453 Enrollment ID: I20060519000085 |
| Provider Name | John M Augustin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225146632 PECOS PAC ID: 1052447869 Enrollment ID: I20100331000830 |
| Provider Name | Alice Coscia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760929269 PECOS PAC ID: 5698041697 Enrollment ID: I20180219000041 |
Primary Care Medical Group Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 450 Bergen St, Harrison, NJ 07029 Phone: 973-484-6900 Fax: 973-484-0029 |