| Mount Prospect Medical Group,llc | |
|
570 Park Ave 2nd Floor East Orange NJ 07017-1904 | |
| (973) 672-8573 | |
| (973) 675-0040 |
| Full Name | Mount Prospect Medical Group,llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 570 Park Ave, East Orange, New Jersey |
| Authorized Official Name and Position | Alexander G Salerno (OWNER/PRESIDENT) |
| Authorized Official Contact | 9736722455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mount Prospect Medical Group,llc 613 Park Ave East Orange NJ 07017-1905 Ph: (973) 672-2455 | Mount Prospect Medical Group,llc 570 Park Ave 2nd Floor East Orange NJ 07017-1904 Ph: (973) 672-8573 |
| NPI Number | 1700245255 |
|---|---|
| Provider Enumeration Date | 02/12/2016 |
| Last Update Date | 02/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700245255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA07308500 (New Jersey) | Primary |
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