| Preventive Plus P.a. | |
|
1 West Ridgewood Avenue Paramus NJ 07652-2359 | |
| (201) 444-3060 | |
| (201) 447-9338 |
| Full Name | Preventive Plus P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 West Ridgewood Avenue, Paramus, New Jersey |
| Authorized Official Name and Position | Jeffrey Scott Liva (OWNER) |
| Authorized Official Contact | 2014443060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Preventive Plus P.a. Po Box 29 Saddle River NJ 07458-0029 Ph: (201) 444-3060 | Preventive Plus P.a. 1 West Ridgewood Avenue Paramus NJ 07652-2359 Ph: (201) 444-3060 |
| NPI Number | 1659426500 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 11/21/2011 |
| Medicare PECOS PAC ID | 5799940094 |
|---|---|
| Medicare Enrollment ID | O20120712000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659426500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jeffrey S Liva |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1912963885 PECOS PAC ID: 7810988649 Enrollment ID: I20120717000241 |
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