| Deptford Internal Medicine Associates Llc | |
|
1132 Cooper Street Suite Three Deptford NJ 08096-3014 | |
| (856) 848-8060 | |
| (856) 848-8038 |
| Full Name | Deptford Internal Medicine Associates Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1132 Cooper Street Suite Three, Deptford, New Jersey |
| Authorized Official Name and Position | Imran Azam Mirza (OWNER) |
| Authorized Official Contact | 7327435910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deptford Internal Medicine Associates Llc Po Box 69 Mickleton NJ 08056-0069 Ph: (856) 848-8060 | Deptford Internal Medicine Associates Llc 1132 Cooper Street Suite Three Deptford NJ 08096-3014 Ph: (856) 848-8060 |
| NPI Number | 1346725561 |
|---|---|
| Provider Enumeration Date | 10/03/2018 |
| Last Update Date | 10/03/2018 |
| Medicare PECOS PAC ID | 1254685142 |
|---|---|
| Medicare Enrollment ID | O20181113000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346725561 | NPI | - | NPPES |
| 25MA08024700 | Other | NJ | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Imran A Mirza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376573204 PECOS PAC ID: 1759474679 Enrollment ID: I20080128000445 |
Wal-mart Pharmacy Store 3422 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2000 Clements Bridge Rd, Deptford, NJ 08096 Phone: 856-384-6740 Fax: 856-384-6742 | |
Welcare Pediatrics Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1132 Cooper St, Deptford, NJ 08096 Phone: 856-848-8060 Fax: 856-848-8038 |