| North Warren Medical Assoc | |
|
Panther Valley Mall, Bldg B Route 517 Hackettstown NJ 07840 | |
| (908) 852-0107 | |
| (908) 850-9160 |
| Full Name | North Warren Medical Assoc |
|---|---|
| Speciality | Family Medicine |
| Location | Panther Valley Mall, Bldg B Route 517, Hackettstown, New Jersey |
| Authorized Official Name and Position | Sanjay K Jain (VICE PRESEDENT) |
| Authorized Official Contact | 9088520107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Warren Medical Assoc Panther Valley Mall, Bldg B Route 517 Hackettstown NJ 07840 Ph: (908) 852-0107 | North Warren Medical Assoc Panther Valley Mall, Bldg B Route 517 Hackettstown NJ 07840 Ph: (908) 852-0107 |
| NPI Number | 1477641074 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1759370166 |
|---|---|
| Medicare Enrollment ID | O20040511000437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477641074 | NPI | - | NPPES |
| 8121907 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sanjay Jain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063455780 PECOS PAC ID: 9133118458 Enrollment ID: I20110308000381 |
| Provider Name | Boris Freyman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184676934 PECOS PAC ID: 5496937773 Enrollment ID: I20110308000422 |
| Provider Name | Min Min Li Ah Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922516871 PECOS PAC ID: 4688935356 Enrollment ID: I20180221002190 |
| Provider Name | Virginie Chavannes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962168401 PECOS PAC ID: 9537546692 Enrollment ID: I20220512000194 |
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