| Diego M Fiorentino Do Facp Llc | |
|
200 South New Road Absecon NJ 08201 | |
| (609) 641-2062 | |
| (609) 641-4633 |
| Full Name | Diego M Fiorentino Do Facp Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 South New Road, Absecon, New Jersey |
| Authorized Official Name and Position | Diego Michael Fiorentino (DOCTOR) |
| Authorized Official Contact | 6096412062 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diego M Fiorentino Do Facp Llc Po Box 876 Absecon NJ 08201 Ph: (609) 641-2062 | Diego M Fiorentino Do Facp Llc 200 South New Road Absecon NJ 08201 Ph: (609) 641-2062 |
| NPI Number | 1043430242 |
|---|---|
| Provider Enumeration Date | 04/27/2007 |
| Last Update Date | 06/10/2008 |
| Medicare PECOS PAC ID | 4284713561 |
|---|---|
| Medicare Enrollment ID | O20080512000633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043430242 | NPI | - | NPPES |
| 1106805 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MB050409 (New Jersey) | Primary |
| 207R00000X | Internal Medicine | MB069439 (New Jersey) | Secondary |
| Provider Name | Diego M Fiorentino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265449326 PECOS PAC ID: 0446284848 Enrollment ID: I20050926000096 |
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