| Hawthorne Family Practice | |
|
1083 Goffle Rd Hawthorne NJ 07506-2025 | |
| (973) 427-2421 | |
| (973) 427-6205 |
| Full Name | Hawthorne Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1083 Goffle Rd, Hawthorne, New Jersey |
| Authorized Official Name and Position | Enas Tuppo (PRESIDENT) |
| Authorized Official Contact | 9734272421 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawthorne Family Practice 1083 Goffle Rd Hawthorne NJ 07506-2025 Ph: (973) 427-2421 | Hawthorne Family Practice 1083 Goffle Rd Hawthorne NJ 07506-2025 Ph: (973) 427-2421 |
| NPI Number | 1588878300 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 11/02/2010 |
| Medicare PECOS PAC ID | 1153227350 |
|---|---|
| Medicare Enrollment ID | O20031209000663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588878300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Enas E Tuppo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346240215 PECOS PAC ID: 8527093186 Enrollment ID: I20101102001269 |
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