| Immedicenter | |
|
1355 Broad St Clifton NJ 07013-4221 | |
| (973) 778-5566 | |
| (973) 778-4044 |
| Full Name | Immedicenter |
|---|---|
| Speciality | Family Medicine |
| Location | 1355 Broad St, Clifton, New Jersey |
| Authorized Official Name and Position | Maria C Squirlock (ADMINISTRATOR) |
| Authorized Official Contact | 9737785566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Immedicenter 1355 Broad St Clifton NJ 07013-4221 Ph: (973) 778-5566 | Immedicenter 1355 Broad St Clifton NJ 07013-4221 Ph: (973) 778-5566 |
| NPI Number | 1275639031 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 03/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275639031 | NPI | - | NPPES |
| CB7304 | Other | NJ | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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