| Liberty Med Associates Llc | |
|
999 Palmer Ave Ste 1 Holmdel NJ 07733 | |
| (732) 267-3313 | |
| Not Available |
| Full Name | Liberty Med Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 999 Palmer Ave Ste 1, Holmdel, New Jersey |
| Authorized Official Name and Position | Joseph John Calabro (CEO) |
| Authorized Official Contact | 7322120051 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Med Associates Llc 66 W Gilbert St Suite 100 Tinton Falls NJ 07701-4947 Ph: (732) 212-0060 | Liberty Med Associates Llc 999 Palmer Ave Ste 1 Holmdel NJ 07733 Ph: (732) 267-3313 |
| NPI Number | 1366983033 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 03/09/2020 |
| Medicare PECOS PAC ID | 7416234075 |
|---|---|
| Medicare Enrollment ID | O20170509000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366983033 | NPI | - | NPPES |
| Provider Name | Roberta F Mennie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760457774 PECOS PAC ID: 1658335039 Enrollment ID: I20041116000235 |
| Provider Name | Christine M Condon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467586743 PECOS PAC ID: 0941249452 Enrollment ID: I20050425001085 |
| Provider Name | Bobby Malik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396804712 PECOS PAC ID: 7416972690 Enrollment ID: I20051006000580 |
| Provider Name | Stephen J Swartz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245211705 PECOS PAC ID: 1355364704 Enrollment ID: I20060111000777 |
| Provider Name | Rajasree V Dasari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811929045 PECOS PAC ID: 5991702235 Enrollment ID: I20061031000190 |
| Provider Name | Nisheet Prasad |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1144258856 PECOS PAC ID: 2365440179 Enrollment ID: I20061109000552 |
| Provider Name | Cristian Vladu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033151451 PECOS PAC ID: 1557314838 Enrollment ID: I20061226000077 |
| Provider Name | Karen A Hibbert Ozuzu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871519728 PECOS PAC ID: 6002818135 Enrollment ID: I20070202000231 |
| Provider Name | Laurie S Nahum |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558361295 PECOS PAC ID: 8123112190 Enrollment ID: I20070921000042 |
| Provider Name | Mohammed A Islam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114938461 PECOS PAC ID: 2365448180 Enrollment ID: I20080820000007 |
| Provider Name | Douglas A Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518161223 PECOS PAC ID: 5395803399 Enrollment ID: I20081020000556 |
| Provider Name | Khaula Khalid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164698445 PECOS PAC ID: 6709945504 Enrollment ID: I20081110000001 |
| Provider Name | Shauna M Abel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558514273 PECOS PAC ID: 0648324509 Enrollment ID: I20090812000617 |
| Provider Name | Christopher W Bader |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447406913 PECOS PAC ID: 6305992256 Enrollment ID: I20090918000253 |
| Provider Name | John L Saporito |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1063516441 PECOS PAC ID: 4789727272 Enrollment ID: I20100205000406 |
| Provider Name | Frederick C Ezon |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1538142187 PECOS PAC ID: 9739371030 Enrollment ID: I20101005000697 |
| Provider Name | Leonardo F Holguin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154632701 PECOS PAC ID: 1850589292 Enrollment ID: I20101229000295 |
| Provider Name | Jianfeng Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295972735 PECOS PAC ID: 3274686753 Enrollment ID: I20110110000171 |
| Provider Name | Jeannette A Loman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134327109 PECOS PAC ID: 8123174414 Enrollment ID: I20111229000348 |
| Provider Name | Sharon W Stark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528163532 PECOS PAC ID: 0749440485 Enrollment ID: I20120404000439 |
| Provider Name | Malik Adnan Ullah Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295905370 PECOS PAC ID: 1951469394 Enrollment ID: I20130207000270 |
| Provider Name | Thomas J Negri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033487152 PECOS PAC ID: 6002060258 Enrollment ID: I20130218000008 |
| Provider Name | Ian R Hersh |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1578725230 PECOS PAC ID: 8426222068 Enrollment ID: I20130218000459 |
| Provider Name | Alice Houck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689911034 PECOS PAC ID: 6800031634 Enrollment ID: I20130328000132 |
| Provider Name | Mekhala Mathure |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588942668 PECOS PAC ID: 3274770029 Enrollment ID: I20130515000022 |
| Provider Name | Lillian Alt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619192028 PECOS PAC ID: 3072649763 Enrollment ID: I20130702000078 |
| Provider Name | Matthew T Czaja |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225354491 PECOS PAC ID: 1951542356 Enrollment ID: I20130727000201 |
| Provider Name | Mohamed M. Bakr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215273818 PECOS PAC ID: 2264673698 Enrollment ID: I20130729000402 |
| Provider Name | Hashmukh R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881895001 PECOS PAC ID: 0244472967 Enrollment ID: I20130809000011 |
| Provider Name | Sapan Haresh Majmundar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215272943 PECOS PAC ID: 4688817398 Enrollment ID: I20130828000550 |
| Provider Name | Tanesha Bruce-owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194046029 PECOS PAC ID: 4981848108 Enrollment ID: I20130910000149 |
| Provider Name | Gohar Petrosyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366753493 PECOS PAC ID: 8527293679 Enrollment ID: I20131028001090 |
| Provider Name | Omar Q Awan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376819243 PECOS PAC ID: 4587808639 Enrollment ID: I20140122000054 |
| Provider Name | Maritza G Parreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215048871 PECOS PAC ID: 9739302076 Enrollment ID: I20140514001022 |
| Provider Name | Tarek Rashid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114125234 PECOS PAC ID: 2466506472 Enrollment ID: I20140825002350 |
| Provider Name | Punit R Jariwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386060507 PECOS PAC ID: 1951520378 Enrollment ID: I20140917002328 |
| Provider Name | Shadi Zandieh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326320870 PECOS PAC ID: 5890914030 Enrollment ID: I20140919001439 |
| Provider Name | Farhan A Malik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437572468 PECOS PAC ID: 5294955290 Enrollment ID: I20140925000389 |
| Provider Name | Shauhab Chaudhry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942599352 PECOS PAC ID: 7719108133 Enrollment ID: I20141028000119 |
| Provider Name | Maya Rose Therattil |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1306930664 PECOS PAC ID: 4880674738 Enrollment ID: I20150203001797 |
| Provider Name | Mehandar Kumar |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790082550 PECOS PAC ID: 0941442560 Enrollment ID: I20150223001312 |
| Provider Name | Ummais N Khan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1649543380 PECOS PAC ID: 1153633524 Enrollment ID: I20150629001118 |
| Provider Name | Shumaila Kashif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578839775 PECOS PAC ID: 3274848312 Enrollment ID: I20150818005027 |
| Provider Name | Megha Chitkara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356739338 PECOS PAC ID: 2466767553 Enrollment ID: I20150819006620 |
| Provider Name | Amy R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225439748 PECOS PAC ID: 6901100163 Enrollment ID: I20160209000108 |
| Provider Name | Mohammad Anwar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104263722 PECOS PAC ID: 0042514796 Enrollment ID: I20160513000135 |
| Provider Name | Diana Alavi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700276680 PECOS PAC ID: 1456644681 Enrollment ID: I20160726002666 |
| Provider Name | Beatrice Nogueira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003885724 PECOS PAC ID: 4688628423 Enrollment ID: I20160811001643 |
| Provider Name | Borislav Kheyson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538590161 PECOS PAC ID: 5496042319 Enrollment ID: I20160921000313 |
| Provider Name | Allison Mullarney |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740656024 PECOS PAC ID: 0840566758 Enrollment ID: I20171020001217 |
| Provider Name | Siu-han Abate |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871884007 PECOS PAC ID: 4385863331 Enrollment ID: I20171113000674 |
| Provider Name | David Maclean Junkin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174780829 PECOS PAC ID: 3577637776 Enrollment ID: I20180103002808 |
| Provider Name | Bing Gong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306238100 PECOS PAC ID: 7214282755 Enrollment ID: I20180625000811 |
| Provider Name | Sudarsan Kollimuttathuillam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902324528 PECOS PAC ID: 2961750849 Enrollment ID: I20180809000700 |
| Provider Name | Milena Kolesnikova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285065557 PECOS PAC ID: 9537381389 Enrollment ID: I20181226000363 |
| Provider Name | Casimir Jedlinski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043667892 PECOS PAC ID: 1850629478 Enrollment ID: I20190821000397 |
| Provider Name | Jemmy P Castor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821649625 PECOS PAC ID: 4486086360 Enrollment ID: I20191114001336 |
| Provider Name | Yehoshua Kessin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255801163 PECOS PAC ID: 6507292778 Enrollment ID: I20200206001324 |
| Provider Name | Eun Hae Chang |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1023484052 PECOS PAC ID: 8426365685 Enrollment ID: I20200219000018 |
| Provider Name | Sandra Marie Ash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891305256 PECOS PAC ID: 2769808799 Enrollment ID: I20200820001810 |
| Provider Name | Abdulhadi A Quadri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811981913 PECOS PAC ID: 3274598115 Enrollment ID: I20210608003827 |
| Provider Name | Dana W Papatheodorou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588957971 PECOS PAC ID: 1759500077 Enrollment ID: I20210915002176 |
| Provider Name | Alexsander Glussky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376286450 PECOS PAC ID: 8628458544 Enrollment ID: I20220708001479 |
| Provider Name | Valentina Lefante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083286629 PECOS PAC ID: 2860881323 Enrollment ID: I20221202000359 |
| Provider Name | Ashley Ferraro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275313215 PECOS PAC ID: 8729424395 Enrollment ID: I20240306002452 |
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