| Radius Telemed, Llc | |
|
2 2nd St Ph 4102 Jersey City NJ 07302-7028 | |
| (201) 294-6209 | |
| Not Available |
| Full Name | Radius Telemed, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2 2nd St Ph 4102, Jersey City, New Jersey |
| Authorized Official Name and Position | Dani Korya (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 2012946209 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radius Telemed, Llc 21 Lincoln Ave Elmwood Park NJ 07407-1614 Ph: (877) 360-1122 | Radius Telemed, Llc 2 2nd St Ph 4102 Jersey City NJ 07302-7028 Ph: (201) 294-6209 |
| NPI Number | 1821618968 |
|---|---|
| Provider Enumeration Date | 04/18/2020 |
| Last Update Date | 04/18/2020 |
| Medicare PECOS PAC ID | 8022417377 |
|---|---|
| Medicare Enrollment ID | O20210519000699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821618968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Dani Korya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235426347 PECOS PAC ID: 4486978749 Enrollment ID: I20150115001966 |
| Provider Name | Nawar Al Obaidi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437511219 PECOS PAC ID: 6608103270 Enrollment ID: I20190806002075 |
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