| Behdokht Daneshvar, Llc | |
|
408 Bethel Rd Suite C-2 Somers Point NJ 08244-2172 | |
| (609) 926-6900 | |
| (609) 926-6995 |
| Full Name | Behdokht Daneshvar, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 408 Bethel Rd, Somers Point, New Jersey |
| Authorized Official Name and Position | Behdokht Daneshvar (OWNER) |
| Authorized Official Contact | 6094850300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behdokht Daneshvar, Llc 1015 New Rd 2nd Floor Northfield NJ 08225-1600 Ph: (609) 926-6900 | Behdokht Daneshvar, Llc 408 Bethel Rd Suite C-2 Somers Point NJ 08244-2172 Ph: (609) 926-6900 |
| NPI Number | 1447512835 |
|---|---|
| Provider Enumeration Date | 06/12/2012 |
| Last Update Date | 06/12/2012 |
| Medicare PECOS PAC ID | 3375790892 |
|---|---|
| Medicare Enrollment ID | O20120905000522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447512835 | NPI | - | NPPES |
| 8024804 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA06958500 (New Jersey) | Primary |
| Provider Name | Behdokht Daneshvar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093745473 PECOS PAC ID: 2062559248 Enrollment ID: I20091020000553 |
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