Universal Medicine, Llc | |
103 River Rd Suite 101 Edgewater NJ 07020-1016 | |
(201) 308-8995 | |
(201) 917-3603 |
Full Name | Universal Medicine, Llc |
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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 |
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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 |
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Provider Enumeration Date | 09/04/2015 |
Last Update Date | 03/29/2024 |
Medicare PECOS PAC ID | 8224348388 |
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Medicare Enrollment ID | O20151103000120 |
Identifier | Type | State | Issuer |
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1649648809 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Domenico Rotoli |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1760700215 PECOS PAC ID: 6002134939 Enrollment ID: I20150406000697 |
Provider Name | Lilia Vento Duharte |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912581737 PECOS PAC ID: 3577939891 Enrollment ID: I20221214000525 |
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