| Milliennieum Gastroenterology Inc | |
|
160 Haledon Ave Prospect Park NJ 07508-2051 | |
| (973) 782-4872 | |
| (973) 782-4873 |
| Full Name | Milliennieum Gastroenterology Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 160 Haledon Ave, Prospect Park, New Jersey |
| Authorized Official Name and Position | Eyad Y Baghal (OWNER) |
| Authorized Official Contact | 9737824872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Milliennieum Gastroenterology Inc Po Box 237 Franklin Lakes NJ 07417-0237 Ph: (973) 782-4872 | Milliennieum Gastroenterology Inc 160 Haledon Ave Prospect Park NJ 07508-2051 Ph: (973) 782-4872 |
| NPI Number | 1326291162 |
|---|---|
| Provider Enumeration Date | 10/24/2008 |
| Last Update Date | 10/03/2023 |
| Medicare PECOS PAC ID | 2860533916 |
|---|---|
| Medicare Enrollment ID | O20100112000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326291162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Michelle Mingqi Ye |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1265504062 PECOS PAC ID: 9234127713 Enrollment ID: I20040504000349 |
| Provider Name | Eyad Y Baghal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093763039 PECOS PAC ID: 5799722013 Enrollment ID: I20050408000369 |
| Provider Name | Michael A Gistrak |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396793972 PECOS PAC ID: 3870665318 Enrollment ID: I20080628000069 |
| Provider Name | Scott Merlin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1124244009 PECOS PAC ID: 2163560897 Enrollment ID: I20091117000348 |
| Provider Name | Barry M Benisch |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1033291109 PECOS PAC ID: 7416095476 Enrollment ID: I20100304000748 |
| Provider Name | Donna Taormina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306231071 PECOS PAC ID: 2365733888 Enrollment ID: I20161004001939 |
| Provider Name | Leila Ledesma-apolinario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255988432 PECOS PAC ID: 5698105484 Enrollment ID: I20230228002603 |
Total Medical Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 Haledon Ave, Prospect Park, NJ 07508 Phone: 973-790-1074 Fax: 973-790-1929 |