| Universal Medicine, Llc | |
|
103 River Rd Suite 101 Edgewater NJ 07020-1016 | |
| (201) 308-8995 | |
| (201) 917-3603 |
| Full Name | Universal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 103 River Rd, Edgewater, New Jersey |
| Authorized Official Name and Position | Domenico Rotoli (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 2013088995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Universal Medicine, Llc 103 River Rd Suite 101 Edgewater NJ 07020-1016 Ph: (201) 308-8995 | Universal Medicine, Llc 103 River Rd Suite 101 Edgewater NJ 07020-1016 Ph: (201) 308-8995 |
| NPI Number | 1649648809 |
|---|---|
| Provider Enumeration Date | 09/04/2015 |
| Last Update Date | 03/29/2024 |
| Medicare PECOS PAC ID | 8224348388 |
|---|---|
| Medicare Enrollment ID | O20151103000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649648809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Domenico Rotoli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760700215 PECOS PAC ID: 6002134939 Enrollment ID: I20150406000697 |
| Provider Name | Sana Naeem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922533165 PECOS PAC ID: 3870862550 Enrollment ID: I20170712001498 |
| Provider Name | Lilia Deneb Vento Valverde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912581737 PECOS PAC ID: 3577939891 Enrollment ID: I20221214000525 |
| Provider Name | Nkechi R Fyle |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1265569941 PECOS PAC ID: 4688119555 Enrollment ID: I20240913002908 |
| Provider Name | Edward Dovlatyan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124629555 PECOS PAC ID: 0345781506 Enrollment ID: I20240916002789 |
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