| Prime Diagnosis Medical P.a. | |
|
1325 Paterson Plank Rd Secaucus NJ 07094-3746 | |
| (201) 583-5232 | |
| (201) 351-4016 |
| Full Name | Prime Diagnosis Medical P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1325 Paterson Plank Rd, Secaucus, New Jersey |
| Authorized Official Name and Position | Vasiliky Tsirogiannis (PRESIDENT) |
| Authorized Official Contact | 5514826186 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Diagnosis Medical P.a. 1325 Paterson Plank Rd Secaucus NJ 07094-3746 Ph: (201) 583-5232 | Prime Diagnosis Medical P.a. 1325 Paterson Plank Rd Secaucus NJ 07094-3746 Ph: (201) 583-5232 |
| NPI Number | 1972986297 |
|---|---|
| Provider Enumeration Date | 07/06/2015 |
| Last Update Date | 12/16/2016 |
| Medicare PECOS PAC ID | 9830407386 |
|---|---|
| Medicare Enrollment ID | O20151001002714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972986297 | NPI | - | NPPES |
| 324655 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA08733800 (New Jersey) | Primary |
| Provider Name | Vasiliky Tsirogiannis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316296544 PECOS PAC ID: 4183876121 Enrollment ID: I20121220000204 |
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