| Dbnj Sports Medicine Specialists | |
|
77 Schanck Rd # 55 Suite B 11 Freehold NJ 07728-2964 | |
| (732) 677-3733 | |
| (732) 677-3734 |
| Full Name | Dbnj Sports Medicine Specialists |
|---|---|
| Speciality | Internal Medicine |
| Location | 77 Schanck Rd # 55, Freehold, New Jersey |
| Authorized Official Name and Position | Dhimant Jitendra Balar (PRESIDENT) |
| Authorized Official Contact | 7326773733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dbnj Sports Medicine Specialists Po Box 6201 Freehold NJ 07728-6201 Ph: (732) 677-3733 | Dbnj Sports Medicine Specialists 77 Schanck Rd # 55 Suite B 11 Freehold NJ 07728-2964 Ph: (732) 677-3733 |
| NPI Number | 1508904699 |
|---|---|
| Provider Enumeration Date | 02/02/2007 |
| Last Update Date | 09/23/2015 |
| Medicare PECOS PAC ID | 4486752227 |
|---|---|
| Medicare Enrollment ID | O20070601000514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508904699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RS0010X | Internal Medicine - Sports Medicine | 0600257676 (New Jersey) | Primary |
| Provider Name | Dhimant J Balar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417001587 PECOS PAC ID: 5496853236 Enrollment ID: I20070601000503 |
| Provider Name | Antoinette Luongo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487965075 PECOS PAC ID: 0143417089 Enrollment ID: I20120330000474 |
| Provider Name | Guillermo Jose Bernal |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1912904137 PECOS PAC ID: 2062447493 Enrollment ID: I20230204000007 |
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