| Essex Renal & Medical Group,llc | |
|
511 S Orange Ave South Orange NJ 07079-2636 | |
| (973) 762-4720 | |
| (973) 762-3731 |
| Full Name | Essex Renal & Medical Group,llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 511 S Orange Ave, South Orange, New Jersey |
| Authorized Official Name and Position | Pooja Malhotra (PRESIDENT) |
| Authorized Official Contact | 9737624720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essex Renal & Medical Group,llc 707 S Orange Ave South Orange NJ 07079-2698 Ph: (973) 762-4720 | Essex Renal & Medical Group,llc 511 S Orange Ave South Orange NJ 07079-2636 Ph: (973) 762-4720 |
| NPI Number | 1972545648 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 07/11/2022 |
| Medicare PECOS PAC ID | 5294708095 |
|---|---|
| Medicare Enrollment ID | O20040819000159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972545648 | NPI | - | NPPES |
| 0023477 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA28189 (New Jersey) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | MA28189 (New Jersey) | Primary |
| Provider Name | Pooja Malhotra |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1376738112 PECOS PAC ID: 1759570799 Enrollment ID: I20110106000805 |
| Provider Name | Saroj Sehgal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871512616 PECOS PAC ID: 2769638725 Enrollment ID: I20120807000185 |
| Provider Name | Julita Wilson-reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336512573 PECOS PAC ID: 9234418229 Enrollment ID: I20161115001536 |
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