| Primary Care Services At The Evergreens | |
|
309 Bridgeboro Road Moorestown NJ 08057 | |
| (410) 778-7300 | |
| (410) 778-0053 |
| Full Name | Primary Care Services At The Evergreens |
|---|---|
| Speciality | Internal Medicine |
| Location | 309 Bridgeboro Road, Moorestown, New Jersey |
| Authorized Official Name and Position | Susan Ahern (SVP, CFO) |
| Authorized Official Contact | 2156618330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Services At The Evergreens 420 Delaware Dr Ft Washington PA 19034-2711 Ph: (267) 787-4097 | Primary Care Services At The Evergreens 309 Bridgeboro Road Moorestown NJ 08057 Ph: (410) 778-7300 |
| NPI Number | 1801363544 |
|---|---|
| Provider Enumeration Date | 10/31/2018 |
| Last Update Date | 01/27/2023 |
| Medicare PECOS PAC ID | 5092032284 |
|---|---|
| Medicare Enrollment ID | O20230227000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801363544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rebecca Castellanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447202569 PECOS PAC ID: 1355354531 Enrollment ID: I20060712000092 |
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