| Mainbridge Medical | |
|
1 Mainbridge Ln Willingboro NJ 08046-2103 | |
| (609) 877-0646 | |
| (609) 877-0370 |
| Full Name | Mainbridge Medical |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Mainbridge Ln, Willingboro, New Jersey |
| Authorized Official Name and Position | Leonard S Katz (OWNER) |
| Authorized Official Contact | 6098770644 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mainbridge Medical Po Box 8627 Cherry Hill NJ 08002-0627 Ph: (856) 755-1616 | Mainbridge Medical 1 Mainbridge Ln Willingboro NJ 08046-2103 Ph: (609) 877-0646 |
| NPI Number | 1972553642 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972553642 | NPI | - | NPPES |
| 019423 | Other | NJ | AMERIHEALTH ADMINISTRATOR |
| 10169 | Other | AETNA HMO | |
| 5868520 | Other | AETNA PPO | |
| 8159009 | Medicaid | NJ | |
| 0471676001 | Other | NJ | AMERIHEALTH HMO/PPO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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