| Montville Family Practice Associates, Pa | |
|
137 Main Road Suite 200 Montville NJ 07045 | |
| (973) 402-0025 | |
| (973) 402-0508 |
| Full Name | Montville Family Practice Associates, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 137 Main Road, Montville, New Jersey |
| Authorized Official Name and Position | Tiffany Percan (CREDENTIAL) |
| Authorized Official Contact | 9734020025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montville Family Practice Associates, Pa 137 Main Road Suite 200 Montville NJ 07045 Ph: (973) 402-0025 | Montville Family Practice Associates, Pa 137 Main Road Suite 200 Montville NJ 07045 Ph: (973) 402-0025 |
| NPI Number | 1841347523 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 06/13/2013 |
| Medicare PECOS PAC ID | 4486640786 |
|---|---|
| Medicare Enrollment ID | O20040422000516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841347523 | NPI | - | NPPES |
| 5003709 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (New Jersey) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | William G Keating |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770670101 PECOS PAC ID: 0446246748 Enrollment ID: I20101022000139 |
| Provider Name | Susan E Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154429660 PECOS PAC ID: 7618929845 Enrollment ID: I20110211000830 |
| Provider Name | Jacqueline Filion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184704934 PECOS PAC ID: 9931381621 Enrollment ID: I20110317000236 |
| Provider Name | Fern D Kumar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992729396 PECOS PAC ID: 1557437597 Enrollment ID: I20130326000082 |
| Provider Name | Rahman Ryan Subrati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932479094 PECOS PAC ID: 1456597467 Enrollment ID: I20130418000024 |
| Provider Name | Nimfa Gabriana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376777821 PECOS PAC ID: 5991950339 Enrollment ID: I20150921002079 |
| Provider Name | Sofia Anna Skulsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912466939 PECOS PAC ID: 6901139021 Enrollment ID: I20190605000456 |
| Provider Name | Megan Theresa Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619749611 PECOS PAC ID: 0547618506 Enrollment ID: I20231130003728 |
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