| Autumn Ridge Primary Care Llc | |
|
3350 Hwy 138 Ste 217 Wall Township NJ 07719-9694 | |
| (732) 974-1980 | |
| (732) 974-8020 |
| Full Name | Autumn Ridge Primary Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3350 Hwy 138 Ste 217, Wall Township, New Jersey |
| Authorized Official Name and Position | Janice Siciliano (PRESIDENT) |
| Authorized Official Contact | 7329741980 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autumn Ridge Primary Care Llc 3350 Hwy 138 Ste 217 Wall Township NJ 07719-9694 Ph: (732) 974-1980 | Autumn Ridge Primary Care Llc 3350 Hwy 138 Ste 217 Wall Township NJ 07719-9694 Ph: (732) 974-1980 |
| NPI Number | 1306471065 |
|---|---|
| Provider Enumeration Date | 03/03/2020 |
| Last Update Date | 08/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306471065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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