| K Primary Care And Medical Nutrition Center | |
|
571 Central Ave Suite 104 New Providence NJ 07974-1547 | |
| (908) 206-4676 | |
| Not Available |
| Full Name | K Primary Care And Medical Nutrition Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 571 Central Ave, New Providence, New Jersey |
| Authorized Official Name and Position | Maureen Doherty (CREDENTIALING CONTACT) |
| Authorized Official Contact | 9082064676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| K Primary Care And Medical Nutrition Center 571 Central Ave Suite 104 New Providence NJ 07974-1547 Ph: (908) 206-4676 | K Primary Care And Medical Nutrition Center 571 Central Ave Suite 104 New Providence NJ 07974-1547 Ph: (908) 206-4676 |
| NPI Number | 1477948362 |
|---|---|
| Provider Enumeration Date | 03/30/2015 |
| Last Update Date | 09/01/2015 |
| Medicare PECOS PAC ID | 5698081289 |
|---|---|
| Medicare Enrollment ID | O20150827000657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477948362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (New Jersey) | Primary |
| Provider Name | Kavita Kewalramani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952528432 PECOS PAC ID: 5890825301 Enrollment ID: I20120126000113 |
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