| South Orange Village Medical Group, Llc | |
|
483 S Orange Ave South Orange NJ 07079-2642 | |
| (973) 638-1634 | |
| Not Available |
| Full Name | South Orange Village Medical Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 483 S Orange Ave, South Orange, New Jersey |
| Authorized Official Name and Position | Amgad Hessein (OWNER) |
| Authorized Official Contact | 9736381634 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Orange Village Medical Group, Llc 483 S Orange Ave South Orange NJ 07079-2642 Ph: (973) 638-1634 | South Orange Village Medical Group, Llc 483 S Orange Ave South Orange NJ 07079-2642 Ph: (973) 638-1634 |
| NPI Number | 1164716544 |
|---|---|
| Provider Enumeration Date | 06/03/2011 |
| Last Update Date | 06/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164716544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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