T.a.e.l.l.c. | |
450 University Ct Brick NJ 08723-6007 | |
(732) 262-3001 | |
(732) 262-3011 |
Full Name | T.a.e.l.l.c. |
---|---|
Speciality | Internal Medicine |
Location | 450 University Ct, Brick, New Jersey |
Authorized Official Name and Position | Tiberiu A. Gross (M.D.) |
Authorized Official Contact | 7322623001 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
T.a.e.l.l.c. 450 University Ct Brick NJ 08723-6007 Ph: (732) 262-3001 | T.a.e.l.l.c. 450 University Ct Brick NJ 08723-6007 Ph: (732) 262-3001 |
NPI Number | 1558430546 |
---|---|
Provider Enumeration Date | 11/06/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 3072616325 |
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Medicare Enrollment ID | O20070307000421 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558430546 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Tiberiu A Gross |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1366478844 PECOS PAC ID: 8123062411 Enrollment ID: I20050617000042 |
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