| Silver Lake Medical, Pc | |
|
727 Joralemon St Belleville NJ 07109-1455 | |
| (973) 751-2060 | |
| (973) 751-2291 |
| Full Name | Silver Lake Medical, Pc |
|---|---|
| Speciality | Pain Medicine - Pain Medicine |
| Location | 727 Joralemon St, Belleville, New Jersey |
| Authorized Official Name and Position | Antonio Ciccone (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9737512060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Silver Lake Medical, Pc Po Box 599 Roseland NJ 07068-0599 Ph: (973) 901-1515 | Silver Lake Medical, Pc 727 Joralemon St Belleville NJ 07109-1455 Ph: (973) 751-2060 |
| NPI Number | 1750875589 |
|---|---|
| Provider Enumeration Date | 06/15/2018 |
| Last Update Date | 06/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750875589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | 25MB05752300 (New Jersey) | Primary |
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