| M T Insetta LLC | |
|
344 Summit Ave Hackensack NJ 07601-1430 | |
| (201) 523-1322 | |
| Not Available |
| Full Name | M T Insetta LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 344 Summit Ave, Hackensack, New Jersey |
| Authorized Official Name and Position | Mark T Insetta (OWNER) |
| Authorized Official Contact | 2015231322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| M T Insetta LLC 344 Summit Ave Hackensack NJ 07601-1430 Ph: (201) 523-1322 | M T Insetta LLC 344 Summit Ave Hackensack NJ 07601-1430 Ph: (201) 523-1322 |
| NPI Number | 1386341527 |
|---|---|
| Provider Enumeration Date | 02/08/2023 |
| Last Update Date | 03/20/2024 |
| Certification Date | 11/22/2023 |
| Medicare PECOS PAC ID | 6204377310 |
|---|---|
| Medicare Enrollment ID | O20240917001457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386341527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
| Provider Name | Mark Insetta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114568094 PECOS PAC ID: 0941649339 Enrollment ID: I20240418000483 |
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