Shore Atlantic Geriatrics Llc | |
1740 Bayshore Road Villas NJ 08251 | |
(609) 886-4441 | |
(609) 889-1766 |
Full Name | Shore Atlantic Geriatrics Llc |
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Speciality | Internal Medicine |
Location | 1740 Bayshore Road, Villas, New Jersey |
Authorized Official Name and Position | Aloysius Chukwumuche Onwuka (MEDICAL DIRECTOR) |
Authorized Official Contact | 6098864441 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Shore Atlantic Geriatrics Llc 1740 Bayshore Road Villas NJ 08251 Ph: (609) 886-4441 | Shore Atlantic Geriatrics Llc 1740 Bayshore Road Villas NJ 08251 Ph: (609) 886-4441 |
NPI Number | 1508882051 |
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Provider Enumeration Date | 07/15/2006 |
Last Update Date | 10/11/2013 |
Medicare PECOS PAC ID | 7416985015 |
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Medicare Enrollment ID | O20050913000092 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508882051 | NPI | - | NPPES |
0039861 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Aloysius Chukwumyche Onwuka |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1659328987 PECOS PAC ID: 5496730483 Enrollment ID: I20040623000532 |
Provider Name | Manoj P Jain |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972717676 PECOS PAC ID: 4981789476 Enrollment ID: I20100329000760 |
Provider Name | Jacqueline Burns |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093892507 PECOS PAC ID: 2567592934 Enrollment ID: I20100610000936 |
Provider Name | Michelle Phillips-cottrell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376979724 PECOS PAC ID: 2062643570 Enrollment ID: I20140326002158 |
Provider Name | John K Tompkins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306247457 PECOS PAC ID: 2668794934 Enrollment ID: I20141124001512 |
Provider Name | Marie Gretta Bernard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760854533 PECOS PAC ID: 6709184765 Enrollment ID: I20160408000087 |
Provider Name | Beth A Taylor |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487106290 PECOS PAC ID: 0941580955 Enrollment ID: I20161209000151 |
Provider Name | Joann Sampolski |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730623216 PECOS PAC ID: 7517243314 Enrollment ID: I20170410002234 |
Shore Atlantic Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1740 Bayshore Rd, Villas, NJ 08251 Phone: 609-886-4441 Fax: 609-889-1766 |