| Liberty Medical Associates, Llc | |
|
506 Central Ave Orange NJ 07050-1432 | |
| (201) 218-8422 | |
| Not Available |
| Full Name | Liberty Medical Associates, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 506 Central Ave, Orange, New Jersey |
| Authorized Official Name and Position | Tariq Mahmood (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2012188422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Medical Associates, Llc 146 Brewster Ave Piscataway NJ 08854-2229 Ph: (201) 218-8422 | Liberty Medical Associates, Llc 506 Central Ave Orange NJ 07050-1432 Ph: (201) 218-8422 |
| NPI Number | 1659125185 |
|---|---|
| Provider Enumeration Date | 04/12/2024 |
| Last Update Date | 04/12/2024 |
| Medicare PECOS PAC ID | 4880125467 |
|---|---|
| Medicare Enrollment ID | O20241007003228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659125185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tariq Mahmood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619386414 PECOS PAC ID: 6204131634 Enrollment ID: I20160223002542 |
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