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74 Us Highway 9 Ste 1 Englishtown NJ 07726-9209 | |
| (732) 762-5005 | |
| (732) 410-4676 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 74 Us Highway 9 Ste 1, Englishtown, New Jersey |
| Authorized Official Name and Position | Jacob Katz (OWNER) |
| Authorized Official Contact | 7327625005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
74 Us Highway 9 Ste 1b Englishtown NJ 07726-9209 Ph: (732) 762-5005 | 74 Us Highway 9 Ste 1 Englishtown NJ 07726-9209 Ph: (732) 762-5005 |
| NPI Number | 1962179317 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 12/11/2024 |
| Medicare PECOS PAC ID | 7810395498 |
|---|---|
| Medicare Enrollment ID | O20211012002677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962179317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Jacob Katz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538387964 PECOS PAC ID: 4284914599 Enrollment ID: I20180209001665 |
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