| Naspac 1 LLC | |
|
202 Rte 37 W Toms River NJ 08755-8055 | |
| (732) 503-4373 | |
| Not Available |
| Full Name | Naspac 1 LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 202 Rte 37 W, Toms River, New Jersey |
| Authorized Official Name and Position | Abhijeet Rastogi (CO CEO) |
| Authorized Official Contact | 9084561398 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Naspac 1 LLC 202 Rte 37 W Toms River NJ 08755-8055 Ph: (732) 551-3950 | Naspac 1 LLC 202 Rte 37 W Toms River NJ 08755-8055 Ph: (732) 503-4373 |
| NPI Number | 1215562301 |
|---|---|
| Provider Enumeration Date | 03/09/2020 |
| Last Update Date | 03/20/2024 |
| Certification Date | 02/08/2024 |
| Medicare PECOS PAC ID | 8022434232 |
|---|---|
| Medicare Enrollment ID | O20200819000764 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215562301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Megan Selnek |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891213021 PECOS PAC ID: 3971879750 Enrollment ID: I20171023001729 |
| Provider Name | Chitra Kodery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538422993 PECOS PAC ID: 8628206984 Enrollment ID: I20180926001157 |
| Provider Name | Kathleena M Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609532548 PECOS PAC ID: 5890187132 Enrollment ID: I20220119001763 |
| Provider Name | Lakshman Sundaram |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1518268341 PECOS PAC ID: 6002270113 Enrollment ID: I20241029001146 |
| Provider Name | Nicole Clyde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407708878 PECOS PAC ID: 2466937230 Enrollment ID: I20260330002264 |
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