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788 Mount Prospect Ave Fl 2 Newark NJ 07104-3221 | |
| (973) 433-9773 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 788 Mount Prospect Ave Fl 2, Newark, New Jersey |
| Authorized Official Name and Position | Nuris Rodriguez-pabon (CEO) |
| Authorized Official Contact | 9734339773 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
788 Mount Prospect Ave Fl 2 Newark NJ 07104-3221 Ph: (973) 433-9773 | 788 Mount Prospect Ave Fl 2 Newark NJ 07104-3221 Ph: (973) 433-9773 |
| NPI Number | 1619568227 |
|---|---|
| Provider Enumeration Date | 01/27/2021 |
| Last Update Date | 03/28/2023 |
| Medicare PECOS PAC ID | 1254748759 |
|---|---|
| Medicare Enrollment ID | O20230424001388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619568227 | NPI | - | NPPES |
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