| Dennis Collaborative Care Llc | |
|
17 Casino Dr Farmingdale NJ 07727-3701 | |
| (732) 255-2252 | |
| (848) 444-8001 |
| Full Name | Dennis Collaborative Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 17 Casino Dr, Farmingdale, New Jersey |
| Authorized Official Name and Position | Philp Dennis (PRESIDENT/REGISTERED AGENT) |
| Authorized Official Contact | 7322552252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dennis Collaborative Care Llc Po Box 303 Allenhurst NJ 07711-0303 Ph: (732) 255-2252 | Dennis Collaborative Care Llc 17 Casino Dr Farmingdale NJ 07727-3701 Ph: (732) 255-2252 |
| NPI Number | 1215462635 |
|---|---|
| Provider Enumeration Date | 04/23/2017 |
| Last Update Date | 06/21/2017 |
| Medicare PECOS PAC ID | 0042589509 |
|---|---|
| Medicare Enrollment ID | O20170627002060 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215462635 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Philip Samuel Dennis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942391313 PECOS PAC ID: 7719955954 Enrollment ID: I20061127000175 |
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