| 165 Summit Internal Medicine Clinic Pa | |
|
165 Summit Ave Hackensack NJ 07601-1311 | |
| (201) 488-5892 | |
| (201) 488-0022 |
| Full Name | 165 Summit Internal Medicine Clinic Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 165 Summit Ave, Hackensack, New Jersey |
| Authorized Official Name and Position | Aret Yegise Kahyaoglu (PRESIDENT) |
| Authorized Official Contact | 2014885892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 165 Summit Internal Medicine Clinic Pa 165 Summit Ave Hackensack NJ 07601-1311 Ph: (201) 488-5892 | 165 Summit Internal Medicine Clinic Pa 165 Summit Ave Hackensack NJ 07601-1311 Ph: (201) 488-5892 |
| NPI Number | 1558690446 |
|---|---|
| Provider Enumeration Date | 12/23/2009 |
| Last Update Date | 12/23/2009 |
| Medicare PECOS PAC ID | 0648307256 |
|---|---|
| Medicare Enrollment ID | O20100429000750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558690446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MA61265NJ (New Jersey) | Primary |
| Provider Name | Aret Y Kahyaoglu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811023682 PECOS PAC ID: 4486693579 Enrollment ID: I20050428000089 |
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