| Panacea Id Health Llc | |
|
20 Overlook Rd Mountain Lakes NJ 07046-1509 | |
| (908) 464-3636 | |
| (908) 464-6711 |
| Full Name | Panacea Id Health Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 20 Overlook Rd, Mountain Lakes, New Jersey |
| Authorized Official Name and Position | Anneta V Golubchik (OWNER) |
| Authorized Official Contact | 9084643636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Panacea Id Health Llc 20 Overlook Rd Mountain Lakes NJ 07046-1509 Ph: (908) 464-3636 | Panacea Id Health Llc 20 Overlook Rd Mountain Lakes NJ 07046-1509 Ph: (908) 464-3636 |
| NPI Number | 1588108062 |
|---|---|
| Provider Enumeration Date | 12/19/2016 |
| Last Update Date | 12/19/2016 |
| Medicare PECOS PAC ID | 1850675091 |
|---|---|
| Medicare Enrollment ID | O20170307000898 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588108062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 25MA08153500 (New Jersey) | Primary |
| Provider Name | Anneta V Golubchik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861511610 PECOS PAC ID: 7618166448 Enrollment ID: I20110111000119 |
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