| New Jersey Cancer And Integrated Medicine Center, Llc | |
|
464 Hudson Ter Ste 200 Englewood Cliffs NJ 07632-2917 | |
| (201) 408-5442 | |
| Not Available |
| Full Name | New Jersey Cancer And Integrated Medicine Center, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 464 Hudson Ter Ste 200, Englewood Cliffs, New Jersey |
| Authorized Official Name and Position | Hai Sun Park (PRESIDENT) |
| Authorized Official Contact | 2014085442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Jersey Cancer And Integrated Medicine Center, Llc 464 Hudson Ter Ste 201 Englewood Cliffs NJ 07632-2917 Ph: () - | New Jersey Cancer And Integrated Medicine Center, Llc 464 Hudson Ter Ste 200 Englewood Cliffs NJ 07632-2917 Ph: (201) 408-5442 |
| NPI Number | 1780150342 |
|---|---|
| Provider Enumeration Date | 10/22/2018 |
| Last Update Date | 03/27/2019 |
| Medicare PECOS PAC ID | 8921345802 |
|---|---|
| Medicare Enrollment ID | O20190130002798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780150342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RH0003X | Internal Medicine - Hematology & Oncology | (* (Not Available)) | Primary |
| Provider Name | Hai S Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508805839 PECOS PAC ID: 7618920133 Enrollment ID: I20050712000571 |
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