Joseph Porter M.d. P.a. | |
50 Mount Prospect Ave Clifton NJ 07013-1900 | |
(973) 574-9880 | |
(973) 574-9819 |
Full Name | Joseph Porter M.d. P.a. |
---|---|
Speciality | Internal Medicine |
Location | 50 Mount Prospect Ave, Clifton, New Jersey |
Authorized Official Name and Position | Joseph Porter (PRESIDENT) |
Authorized Official Contact | 9735749880 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Joseph Porter M.d. P.a. 50 Mount Prospect Ave Clifton NJ 07013-1900 Ph: (973) 574-9880 | Joseph Porter M.d. P.a. 50 Mount Prospect Ave Clifton NJ 07013-1900 Ph: (973) 574-9880 |
NPI Number | 1023348232 |
---|---|
Provider Enumeration Date | 01/11/2010 |
Last Update Date | 01/11/2010 |
Medicare PECOS PAC ID | 8921141938 |
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Medicare Enrollment ID | O20100129000494 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023348232 | NPI | - | NPPES |
1569201 | Medicaid | NJ | |
11022326 | Other | NJ | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MA46587 (New Jersey) | Primary |
Provider Name | Joseph M Porter |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1639264393 PECOS PAC ID: 9133261324 Enrollment ID: I20100127000043 |
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