| Wayne Medical Health Professional Corporation | |
|
510 Hamburg Tpke Ste 208 Wayne NJ 07470-2033 | |
| (973) 904-3480 | |
| Not Available |
| Full Name | Wayne Medical Health Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 510 Hamburg Tpke Ste 208, Wayne, New Jersey |
| Authorized Official Name and Position | Magda Eraiba (OWNER) |
| Authorized Official Contact | 9739043480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne Medical Health Professional Corporation 510 Hamburg Tpke Ste 208 Wayne NJ 07470-2033 Ph: (973) 904-3480 | Wayne Medical Health Professional Corporation 510 Hamburg Tpke Ste 208 Wayne NJ 07470-2033 Ph: (973) 904-3480 |
| NPI Number | 1497118590 |
|---|---|
| Provider Enumeration Date | 04/05/2016 |
| Last Update Date | 09/13/2016 |
| Medicare PECOS PAC ID | 3678851219 |
|---|---|
| Medicare Enrollment ID | O20161102000027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497118590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA05764700 (New Jersey) | Primary |
| Provider Name | Magda Eraiba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841327384 PECOS PAC ID: 5193761724 Enrollment ID: I20050708000019 |
| Provider Name | Melissa Gaydos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154665743 PECOS PAC ID: 0143576454 Enrollment ID: I20180628002205 |
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