| Irvington Family Medicine | |
|
852 18th Ave Irvington NJ 07111-2756 | |
| (973) 373-3000 | |
| Not Available |
| Full Name | Irvington Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 852 18th Ave, Irvington, New Jersey |
| Authorized Official Name and Position | Melloney Jackson (PARTNER) |
| Authorized Official Contact | 9733733000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Irvington Family Medicine 12 Krotik Pl Irvington NJ 07111-1708 Ph: (973) 373-3000 | Irvington Family Medicine 852 18th Ave Irvington NJ 07111-2756 Ph: (973) 373-3000 |
| NPI Number | 1720303621 |
|---|---|
| Provider Enumeration Date | 04/02/2010 |
| Last Update Date | 04/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720303621 | NPI | - | NPPES |
| 0887307 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MA04275 (New Jersey) | Primary |
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