| Montclair Adult Care | |
|
239 Claremont Ave Montclair NJ 07042-2833 | |
| (973) 338-3300 | |
| (973) 338-0400 |
| Full Name | Montclair Adult Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 239 Claremont Ave, Montclair, New Jersey |
| Authorized Official Name and Position | Rekha Miryala (MD) |
| Authorized Official Contact | 9733383300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montclair Adult Care 239 Claremont Ave Montclair NJ 07042-2833 Ph: (973) 338-3300 | Montclair Adult Care 239 Claremont Ave Montclair NJ 07042-2833 Ph: (973) 338-3300 |
| NPI Number | 1033429758 |
|---|---|
| Provider Enumeration Date | 10/15/2010 |
| Last Update Date | 05/20/2014 |
| Medicare PECOS PAC ID | 6507048477 |
|---|---|
| Medicare Enrollment ID | O20110314000869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033429758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA08463200 (New Jersey) | Primary |
| Provider Name | Rekha Miryala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942486568 PECOS PAC ID: 8729145958 Enrollment ID: I20101214000573 |
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