| Medical Nutrition Associates Pa | |
|
4 Perry St Morristown NJ 07960-9447 | |
| (973) 540-1000 | |
| (973) 540-0001 |
| Full Name | Medical Nutrition Associates Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 4 Perry St, Morristown, New Jersey |
| Authorized Official Name and Position | Jay J. Graham (BILLING MANAGER) |
| Authorized Official Contact | 9734329014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Nutrition Associates Pa Po Box 2227 Morristown NJ 07962-2227 Ph: (973) 540-1000 | Medical Nutrition Associates Pa 4 Perry St Morristown NJ 07960-9447 Ph: (973) 540-1000 |
| NPI Number | 1881738235 |
|---|---|
| Provider Enumeration Date | 02/19/2007 |
| Last Update Date | 08/17/2009 |
| Medicare PECOS PAC ID | 8820060247 |
|---|---|
| Medicare Enrollment ID | O20040806000965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881738235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA070526 (New Jersey) | Primary |
| Provider Name | Carla Dicenzo-flynn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114942075 PECOS PAC ID: 3870565286 Enrollment ID: I20040806000923 |
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