| Owen Carolan Md Llc | |
|
1640 Route 88 Suite 203 Brick NJ 08724-3068 | |
| (732) 458-7777 | |
| (732) 458-6741 |
| Full Name | Owen Carolan Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1640 Route 88, Brick, New Jersey |
| Authorized Official Name and Position | Owen J Carolan (OWNER) |
| Authorized Official Contact | 7324587777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Owen Carolan Md Llc 1640 Route 88 Suite 203 Brick NJ 08724-3068 Ph: (732) 458-7777 | Owen Carolan Md Llc 1640 Route 88 Suite 203 Brick NJ 08724-3068 Ph: (732) 458-7777 |
| NPI Number | 1437341526 |
|---|---|
| Provider Enumeration Date | 08/13/2007 |
| Last Update Date | 08/13/2007 |
| Medicare PECOS PAC ID | 3870683634 |
|---|---|
| Medicare Enrollment ID | O20071217000396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437341526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA08284800 (New Jersey) | Primary |
| Provider Name | Owen J Carolan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134310667 PECOS PAC ID: 7618067471 Enrollment ID: I20071217000385 |
| Provider Name | Michael Zito Govert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396262200 PECOS PAC ID: 2668731282 Enrollment ID: I20180105000070 |
| Provider Name | Shannon M Macrina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871258343 PECOS PAC ID: 7214321181 Enrollment ID: I20220218002475 |
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