| Riverside Health Care Llc | |
|
115 Broad Ave Palisades Park NJ 07650-1441 | |
| (201) 592-5959 | |
| (201) 592-5955 |
| Full Name | Riverside Health Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 115 Broad Ave, Palisades Park, New Jersey |
| Authorized Official Name and Position | Hangjun Jang (OWNER) |
| Authorized Official Contact | 2015925959 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Health Care Llc 115 Broad Ave Palisades Park NJ 07650-1441 Ph: (201) 592-5959 | Riverside Health Care Llc 115 Broad Ave Palisades Park NJ 07650-1441 Ph: (201) 592-5959 |
| NPI Number | 1497108559 |
|---|---|
| Provider Enumeration Date | 07/13/2016 |
| Last Update Date | 11/07/2023 |
| Medicare PECOS PAC ID | 2365718756 |
|---|---|
| Medicare Enrollment ID | O20171031001049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497108559 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Hangjun Jang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568607919 PECOS PAC ID: 5395802466 Enrollment ID: I20171031001347 |
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