| Professional Oral Surgery Alliance Of New Jersey, Llc | |
|
1530 Palisade Ave Fort Lee NJ 07024-5471 | |
| (201) 585-8282 | |
| Not Available |
| Full Name | Professional Oral Surgery Alliance Of New Jersey, Llc |
|---|---|
| Speciality | Dentist |
| Location | 1530 Palisade Ave, Fort Lee, New Jersey |
| Authorized Official Name and Position | Lauren Howard (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7575765479 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Oral Surgery Alliance Of New Jersey, Llc 11 S Mill St New Castle PA 16101-3680 Ph: () - | Professional Oral Surgery Alliance Of New Jersey, Llc 1530 Palisade Ave Fort Lee NJ 07024-5471 Ph: (201) 585-8282 |
| NPI Number | 1366051195 |
|---|---|
| Provider Enumeration Date | 07/28/2020 |
| Last Update Date | 07/28/2020 |
| Medicare PECOS PAC ID | 9436504404 |
|---|---|
| Medicare Enrollment ID | O20231011000927 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366051195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Vincent Carrao |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1417945767 PECOS PAC ID: 6901868405 Enrollment ID: I20041027000946 |
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