| Kingdom Primary Care | |
|
1300 Princess Ave Camden NJ 08103-2911 | |
| (856) 272-3600 | |
| Not Available |
| Full Name | Kingdom Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 1300 Princess Ave, Camden, New Jersey |
| Authorized Official Name and Position | Lauren Gotay (PROVIDER) |
| Authorized Official Contact | 8565354100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdom Primary Care 3900 City Ave Apt W904 Philadelphia PA 19131-2969 Ph: () - | Kingdom Primary Care 1300 Princess Ave Camden NJ 08103-2911 Ph: (856) 272-3600 |
| NPI Number | 1912663584 |
|---|---|
| Provider Enumeration Date | 11/09/2021 |
| Last Update Date | 02/03/2023 |
| Medicare PECOS PAC ID | 2264819507 |
|---|---|
| Medicare Enrollment ID | O20220506001440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912663584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lauren Gotay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215462957 PECOS PAC ID: 2668895897 Enrollment ID: I20220506001508 |
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