| Evergreen Physicians Of North Jersey, Pc | |
|
96 Parkway Evergreen Physicians Of North Jersey, Pc Rochelle Park NJ 07662-4200 | |
| (973) 450-2540 | |
| (919) 425-0478 |
| Full Name | Evergreen Physicians Of North Jersey, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 96 Parkway, Rochelle Park, New Jersey |
| Authorized Official Name and Position | Kathy Kondas (OFFICER) |
| Authorized Official Contact | 9732511132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Physicians Of North Jersey, Pc 3114 Croasdaile Dr Ste 200 Evergreen Physicians Of North Jersey, Pc Durham NC 27705-2508 Ph: (954) 838-2371 | Evergreen Physicians Of North Jersey, Pc 96 Parkway Evergreen Physicians Of North Jersey, Pc Rochelle Park NJ 07662-4200 Ph: (973) 450-2540 |
| NPI Number | 1912956152 |
|---|---|
| Provider Enumeration Date | 05/06/2006 |
| Last Update Date | 12/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912956152 | NPI | - | NPPES |
| 0102091 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MB06960500 (New Jersey) | Primary |
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