| Livingston Subspecialty Group, P.a. | |
|
349 E Northfield Rd Suite 200 Livingston NJ 07039-4802 | |
| (973) 597-0900 | |
| (973) 597-0910 |
| Full Name | Livingston Subspecialty Group, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 349 E Northfield Rd, Livingston, New Jersey |
| Authorized Official Name and Position | Michael Botti (CONTROLLER) |
| Authorized Official Contact | 9735971690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livingston Subspecialty Group, P.a. 349 E Northfield Rd Suite 200 Livingston NJ 07039-4802 Ph: (973) 597-0900 | Livingston Subspecialty Group, P.a. 349 E Northfield Rd Suite 200 Livingston NJ 07039-4802 Ph: (973) 597-0900 |
| NPI Number | 1437178449 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 03/24/2015 |
| Medicare PECOS PAC ID | 3173578234 |
|---|---|
| Medicare Enrollment ID | O20050322000455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437178449 | NPI | - | NPPES |
| 3457109 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | MA045093 (New Jersey) | Secondary |
| 207RH0003X | Internal Medicine - Hematology & Oncology | MA045092 (New Jersey) | Primary |
| Provider Name | Jennifer R Peos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710986195 PECOS PAC ID: 2961422241 Enrollment ID: I20051201000322 |
| Provider Name | Anthony Botti |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1598787640 PECOS PAC ID: 9830372481 Enrollment ID: I20110322000366 |
| Provider Name | Gigi Randy Diamond |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1295757359 PECOS PAC ID: 4385827930 Enrollment ID: I20110322000396 |
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