| Liberty Primary Care Llc | |
|
1749 Hooper Ave Ste 203 Toms River NJ 08753-8130 | |
| (732) 864-7030 | |
| (732) 864-7032 |
| Full Name | Liberty Primary Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1749 Hooper Ave Ste 203, Toms River, New Jersey |
| Authorized Official Name and Position | Vinodrai Ghetiya (OWNER) |
| Authorized Official Contact | 7328647030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Primary Care Llc 1749 Hooper Ave Ste 203 Toms River NJ 08753-8130 Ph: (732) 864-7030 | Liberty Primary Care Llc 1749 Hooper Ave Ste 203 Toms River NJ 08753-8130 Ph: (732) 864-7030 |
| NPI Number | 1699262295 |
|---|---|
| Provider Enumeration Date | 04/18/2018 |
| Last Update Date | 04/18/2018 |
| Medicare PECOS PAC ID | 3678829470 |
|---|---|
| Medicare Enrollment ID | O20180710000913 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699262295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Vinodrai V Ghetiya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568410249 PECOS PAC ID: 7012103898 Enrollment ID: I20101118000900 |
| Provider Name | Savan Ghetiya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124409057 PECOS PAC ID: 6305192105 Enrollment ID: I20180710001079 |
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