| Vance Medical Group | |
|
703 Main St Paterson NJ 07503-2621 | |
| (973) 754-2000 | |
| Not Available |
| Full Name | Vance Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 703 Main St, Paterson, New Jersey |
| Authorized Official Name and Position | Sourav Sen (AUTH REP) |
| Authorized Official Contact | 9736538076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vance Medical Group 98 George St Tenafly NJ 07670-2011 Ph: () - | Vance Medical Group 703 Main St Paterson NJ 07503-2621 Ph: (973) 754-2000 |
| NPI Number | 1053887596 |
|---|---|
| Provider Enumeration Date | 10/23/2018 |
| Last Update Date | 10/23/2018 |
| Medicare PECOS PAC ID | 5294076683 |
|---|---|
| Medicare Enrollment ID | O20190412000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053887596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sourav Sen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417167693 PECOS PAC ID: 4284780537 Enrollment ID: I20090929000066 |
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