Luis Benalcazar, Md | |
310 Morris Ave Suite 301 Elizabeth NJ 07208-3695 | |
(908) 353-3628 | |
(908) 353-3625 |
Full Name | Luis Benalcazar, Md |
---|---|
Speciality | Internal Medicine |
Location | 310 Morris Ave, Elizabeth, New Jersey |
Authorized Official Name and Position | Luis Benalcazar (MEDICAL DIRECTOR) |
Authorized Official Contact | 9083533628 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Luis Benalcazar, Md 310 Morris Ave Suite 301 Elizabeth NJ 07208-3695 Ph: (908) 353-3628 | Luis Benalcazar, Md 310 Morris Ave Suite 301 Elizabeth NJ 07208-3695 Ph: (908) 353-3628 |
NPI Number | 1083801799 |
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Provider Enumeration Date | 09/26/2007 |
Last Update Date | 09/26/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083801799 | NPI | - | NPPES |
0028410 | Medicaid | NJ | |
075232SRA | Other | NJ | CMS RENDERING NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 25MA07504600 (New Jersey) | Primary |
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