| Immedicenter Bloomfield | |
|
557 Broad St Bloomfield NJ 07003-2885 | |
| (973) 680-8300 | |
| (973) 743-5601 |
| Full Name | Immedicenter Bloomfield |
|---|---|
| Speciality | Family Medicine |
| Location | 557 Broad St, Bloomfield, New Jersey |
| Authorized Official Name and Position | Maria C Squirlock (ADMINISTRATOR) |
| Authorized Official Contact | 9737785566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Immedicenter Bloomfield 557 Broad St Bloomfield NJ 07003-2885 Ph: (973) 680-8300 | Immedicenter Bloomfield 557 Broad St Bloomfield NJ 07003-2885 Ph: (973) 680-8300 |
| NPI Number | 1023114899 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 03/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023114899 | NPI | - | NPPES |
| CB4172 | Other | NJ | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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