| Rosa Ital, Md Inc | |
|
1140 Burnt Tavern Rd Ste 2a Brick NJ 08724-1496 | |
| (732) 202-7307 | |
| (732) 349-5229 |
| Full Name | Rosa Ital, Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1140 Burnt Tavern Rd Ste 2a, Brick, New Jersey |
| Authorized Official Name and Position | Rosa Ital (OWNER) |
| Authorized Official Contact | 7322817140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosa Ital, Md Inc 31 Citation Dr Freehold NJ 07728-4659 Ph: (732) 281-7140 | Rosa Ital, Md Inc 1140 Burnt Tavern Rd Ste 2a Brick NJ 08724-1496 Ph: (732) 202-7307 |
| NPI Number | 1124668629 |
|---|---|
| Provider Enumeration Date | 01/13/2020 |
| Last Update Date | 01/13/2020 |
| Medicare PECOS PAC ID | 6406282227 |
|---|---|
| Medicare Enrollment ID | O20200213002722 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124668629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rosa Ital |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831178235 PECOS PAC ID: 9638139116 Enrollment ID: I20041019000459 |
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