| Menlo Park Medical Group P.a. | |
|
111 James Street Edison NJ 08820-3967 | |
| (732) 549-2299 | |
| (732) 549-2262 |
| Full Name | Menlo Park Medical Group P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 111 James Street, Edison, New Jersey |
| Authorized Official Name and Position | Grace Creighton (OFFICE MANAGER) |
| Authorized Official Contact | 7325492299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Menlo Park Medical Group P.a. 111 James Street Edison NJ 08820-3967 Ph: (732) 549-2299 | Menlo Park Medical Group P.a. 111 James Street Edison NJ 08820-3967 Ph: (732) 549-2299 |
| NPI Number | 1992727564 |
|---|---|
| Provider Enumeration Date | 07/24/2006 |
| Last Update Date | 08/08/2023 |
| Medicare PECOS PAC ID | 2769677301 |
|---|---|
| Medicare Enrollment ID | O20101109001146 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992727564 | NPI | - | NPPES |
| 2627809 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Primary |
| Provider Name | Warren G Buck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720019532 PECOS PAC ID: 8729011200 Enrollment ID: I20050915000041 |
| Provider Name | Girija G Bhakey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184646754 PECOS PAC ID: 0345435665 Enrollment ID: I20101112000343 |
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