Mayor Group, Llc | |
311 S Livingston Ave Livingston NJ 07039-3927 | |
(973) 994-0221 | |
Not Available |
Full Name | Mayor Group, Llc |
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Speciality | Internal Medicine |
Location | 311 S Livingston Ave, Livingston, New Jersey |
Authorized Official Name and Position | Gilbert Mayor (OWNER) |
Authorized Official Contact | 9739987993 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mayor Group, Llc Po Box 303 Mount Freedom NJ 07970-0303 Ph: (973) 998-7993 | Mayor Group, Llc 311 S Livingston Ave Livingston NJ 07039-3927 Ph: (973) 994-0221 |
NPI Number | 1154618874 |
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Provider Enumeration Date | 07/01/2011 |
Last Update Date | 07/01/2011 |
Medicare PECOS PAC ID | 4082884259 |
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Medicare Enrollment ID | O20110825000170 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154618874 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 25MA06640100 (New Jersey) | Primary |
Provider Name | Jacquelin Holubka |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1174577373 PECOS PAC ID: 9638070147 Enrollment ID: I20040420000973 |
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