| Englewood Family Health Center, P.a | |
|
148 Engle St Englewood NJ 07631-2581 | |
| (201) 569-1530 | |
| (201) 569-6022 |
| Full Name | Englewood Family Health Center, P.a |
|---|---|
| Speciality | Internal Medicine |
| Location | 148 Engle St, Englewood, New Jersey |
| Authorized Official Name and Position | Diana M Portilla (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2019261828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Englewood Family Health Center, P.a 148 Engle Street, Suite Number 1 Englewood NJ 07631-2581 Ph: (201) 569-1530 | Englewood Family Health Center, P.a 148 Engle St Englewood NJ 07631-2581 Ph: (201) 569-1530 |
| NPI Number | 1366693145 |
|---|---|
| Provider Enumeration Date | 10/10/2008 |
| Last Update Date | 05/10/2023 |
| Medicare PECOS PAC ID | 0345421939 |
|---|---|
| Medicare Enrollment ID | O20110302000679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366693145 | NPI | - | NPPES |
| 0611859 | Medicaid | NJ | |
| G11493 | Other | NJ | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rafael Latorre |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629158407 PECOS PAC ID: 1951346840 Enrollment ID: I20050622000009 |
| Provider Name | Diana M Portilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487769923 PECOS PAC ID: 6204019946 Enrollment ID: I20110317000832 |
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