| Garden State Bariatrics & Wellness Center,llc | |
|
225 Millburn Ave Suite 204 Millburn NJ 07041-1737 | |
| (973) 218-1990 | |
| (973) 629-1274 |
| Full Name | Garden State Bariatrics & Wellness Center,llc |
|---|---|
| Speciality | Family Medicine |
| Location | 225 Millburn Ave, Millburn, New Jersey |
| Authorized Official Name and Position | Michael L Bilof (OWNER) |
| Authorized Official Contact | 9732181990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden State Bariatrics & Wellness Center,llc 225 Millburn Ave Suite 204 Millburn NJ 07041-1737 Ph: (973) 218-1990 | Garden State Bariatrics & Wellness Center,llc 225 Millburn Ave Suite 204 Millburn NJ 07041-1737 Ph: (973) 218-1990 |
| NPI Number | 1104008374 |
|---|---|
| Provider Enumeration Date | 11/29/2007 |
| Last Update Date | 02/08/2010 |
| Medicare PECOS PAC ID | 4981794336 |
|---|---|
| Medicare Enrollment ID | O20071221000274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104008374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QB0002X | Family Medicine - Obesity Medicine | NJ25MA05641900 (New Jersey) | Primary |
| 261QH0100X | Clinic/center - Health Service | NJ25MA05641900 (New Jersey) | Secondary |
| Provider Name | Michael L Bilof |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1891723136 PECOS PAC ID: 7113990938 Enrollment ID: I20040818001044 |
| Provider Name | Basil M Yurcisin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003062050 PECOS PAC ID: 5799835047 Enrollment ID: I20101102000966 |
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Associates In Primary Care, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 25 E Willow St, Millburn, NJ 07041 Phone: 973-379-5055 Fax: 973-379-5324 | |
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