| Park Ave Medical Centre Llc | |
|
535 Getty Ave Suite 3 Clifton NJ 07011-2105 | |
| (862) 239-4808 | |
| Not Available |
| Full Name | Park Ave Medical Centre Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 535 Getty Ave, Clifton, New Jersey |
| Authorized Official Name and Position | Rafath K Humera (SOLE PROPREITER) |
| Authorized Official Contact | 8622394808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Ave Medical Centre Llc 1367 Ratzer Rd Wayne NJ 07470-2429 Ph: (862) 239-4808 | Park Ave Medical Centre Llc 535 Getty Ave Suite 3 Clifton NJ 07011-2105 Ph: (862) 239-4808 |
| NPI Number | 1447533773 |
|---|---|
| Provider Enumeration Date | 09/22/2011 |
| Last Update Date | 09/22/2011 |
| Medicare PECOS PAC ID | 5092986901 |
|---|---|
| Medicare Enrollment ID | O20110927000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447533773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA08760600 (New Jersey) | Primary |
| Provider Name | Rafath Humera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376871202 PECOS PAC ID: 3476681958 Enrollment ID: I20110927000208 |
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