Kretov Medical Arts Llc | |
1806 Rte 35 Ste 105 Oakhurst NJ 07755-2766 | |
(732) 414-2005 | |
(732) 414-2006 |
Full Name | Kretov Medical Arts Llc |
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Speciality | Clinic/Center |
Location | 1806 Rte 35 Ste 105, Oakhurst, New Jersey |
Authorized Official Name and Position | Aleksey Kretov (PHYSICIAN) |
Authorized Official Contact | 7324142005 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kretov Medical Arts Llc 1806 Rte 35 Ste 105 Oakhurst NJ 07755-2766 Ph: (732) 414-2005 | Kretov Medical Arts Llc 1806 Rte 35 Ste 105 Oakhurst NJ 07755-2766 Ph: (732) 414-2005 |
NPI Number | 1154505907 |
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Provider Enumeration Date | 12/27/2007 |
Last Update Date | 04/21/2023 |
Medicare PECOS PAC ID | 3072697465 |
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Medicare Enrollment ID | O20080225000054 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154505907 | NPI | - | NPPES |
0166570 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | 25MA08294000 (New Jersey) | Primary |
261QP2300X | Clinic/center - Primary Care | 25MA08294000 (New Jersey) | Secondary |
Provider Name | Aleksey Kretov |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1811184211 PECOS PAC ID: 2567546955 Enrollment ID: I20080225000023 |
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