| Clinical Specialist, Llc | |
|
1420 S New Rd Pleasantville NJ 08232-3728 | |
| (609) 200-5117 | |
| (609) 939-3671 |
| Full Name | Clinical Specialist, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1420 S New Rd, Pleasantville, New Jersey |
| Authorized Official Name and Position | Ellen D Doyle (OWNWER/PROVIDER) |
| Authorized Official Contact | 6092005117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Specialist, Llc 1420 S New Rd Pleasantville NJ 08232-3728 Ph: (609) 200-5117 | Clinical Specialist, Llc 1420 S New Rd Pleasantville NJ 08232-3728 Ph: (609) 200-5117 |
| NPI Number | 1366908303 |
|---|---|
| Provider Enumeration Date | 02/14/2019 |
| Last Update Date | 05/20/2022 |
| Certification Date | 07/09/2020 |
| Medicare PECOS PAC ID | 8820339906 |
|---|---|
| Medicare Enrollment ID | O20190418001703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366908303 | NPI | - | NPPES |
| 601369570 | Other | NJ | MAGELLAN |
| 2105250 | Other | WELLCARE | |
| 0673218 | Medicaid | NJ | |
| 1029561 | Other | NJ | BEACONHORIZON |
| Provider Name | Ellen D Doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174774061 PECOS PAC ID: 4880738707 Enrollment ID: I20190418001831 |
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