| Atlantic Primary Care Pc | |
|
72 W Jimmie Leeds Rd Suite 2100 Galloway NJ 08205-9406 | |
| (609) 652-1115 | |
| (609) 652-1145 |
| Full Name | Atlantic Primary Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 72 W Jimmie Leeds Rd, Galloway, New Jersey |
| Authorized Official Name and Position | Vivkekkumar V Dasondi (OWNER) |
| Authorized Official Contact | 6096521115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlantic Primary Care Pc Po Box 195 Northfield NJ 08225-0195 Ph: (609) 926-6900 | Atlantic Primary Care Pc 72 W Jimmie Leeds Rd Suite 2100 Galloway NJ 08205-9406 Ph: (609) 652-1115 |
| NPI Number | 1174786842 |
|---|---|
| Provider Enumeration Date | 07/03/2008 |
| Last Update Date | 12/04/2012 |
| Medicare PECOS PAC ID | 5890869366 |
|---|---|
| Medicare Enrollment ID | O20080731000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174786842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA08110600 (New Jersey) | Primary |
| Provider Name | Lisa L Kern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104989961 PECOS PAC ID: 6002841772 Enrollment ID: I20051007000671 |
| Provider Name | Vivekkumar V Dasondi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528129509 PECOS PAC ID: 9032200852 Enrollment ID: I20070808000797 |
| Provider Name | Claire Sloyan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699829317 PECOS PAC ID: 4183803810 Enrollment ID: I20110126000825 |
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