| Sports Medicine 360 Llc | |
|
14-20 Watsessing Ave Bloomfield NJ 07003-4611 | |
| (973) 748-0067 | |
| Not Available |
| Full Name | Sports Medicine 360 Llc |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 14-20 Watsessing Ave, Bloomfield, New Jersey |
| Authorized Official Name and Position | Dina Degregorio (MANAGER) |
| Authorized Official Contact | 9737480067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sports Medicine 360 Llc 14-20 Watsessing Ave Bloomfield NJ 07003-4611 Ph: (973) 748-0067 | Sports Medicine 360 Llc 14-20 Watsessing Ave Bloomfield NJ 07003-4611 Ph: (973) 748-0067 |
| NPI Number | 1629419163 |
|---|---|
| Provider Enumeration Date | 07/12/2013 |
| Last Update Date | 07/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629419163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 0400560133 (New Jersey) | Primary |
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