| Lafayette Medical Center, Llc | |
|
390 New York Ave Newark NJ 07105-3125 | |
| (973) 344-3518 | |
| (973) 344-1167 |
| Full Name | Lafayette Medical Center, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 390 New York Ave, Newark, New Jersey |
| Authorized Official Name and Position | Renee Julie Cabaleiro (DOCTOR) |
| Authorized Official Contact | 9733443518 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lafayette Medical Center, Llc 390 New York Ave Newark NJ 07105-3125 Ph: (973) 344-3518 | Lafayette Medical Center, Llc 390 New York Ave Newark NJ 07105-3125 Ph: (973) 344-3518 |
| NPI Number | 1144307166 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 07/12/2010 |
| Medicare PECOS PAC ID | 3476509555 |
|---|---|
| Medicare Enrollment ID | O20050323000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144307166 | NPI | - | NPPES |
| 2018802 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Paul J Arias |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255482022 PECOS PAC ID: 4688619596 Enrollment ID: I20050622000169 |
| Provider Name | Renee Cabaleiro |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407907256 PECOS PAC ID: 4082634357 Enrollment ID: I20110602000523 |
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