| Center For Dynamic Aging, Llc | |
|
1530 Palisade Ave Fort Lee NJ 07024-5471 | |
| (201) 363-8871 | |
| (201) 363-8873 |
| Full Name | Center For Dynamic Aging, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1530 Palisade Ave, Fort Lee, New Jersey |
| Authorized Official Name and Position | Terri F Katz (PRESIDENT) |
| Authorized Official Contact | 2013638871 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Dynamic Aging, Llc 1530 Palisade Ave Fort Lee NJ 07024-5471 Ph: (201) 363-8871 | Center For Dynamic Aging, Llc 1530 Palisade Ave Fort Lee NJ 07024-5471 Ph: (201) 363-8871 |
| NPI Number | 1235576109 |
|---|---|
| Provider Enumeration Date | 05/31/2013 |
| Last Update Date | 05/31/2013 |
| Medicare PECOS PAC ID | 0143464396 |
|---|---|
| Medicare Enrollment ID | O20130910000577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235576109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA063457 (New Jersey) | Primary |
| Provider Name | Inderpreet Sachar |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1619141561 PECOS PAC ID: 0941374839 Enrollment ID: I20080812000084 |
| Provider Name | Terri F Katz |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1588764005 PECOS PAC ID: 3476696345 Enrollment ID: I20100202000094 |
| Provider Name | Linda Dillman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871649269 PECOS PAC ID: 7618150665 Enrollment ID: I20110329000252 |
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