| Integrated Medical Associates Llc | |
|
48 N Fullerton Ave Montclair NJ 07042-3411 | |
| (973) 744-7337 | |
| (973) 744-5035 |
| Full Name | Integrated Medical Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 48 N Fullerton Ave, Montclair, New Jersey |
| Authorized Official Name and Position | Rowen Gumapas Diano (OWNER) |
| Authorized Official Contact | 9737447337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Medical Associates Llc 48 N Fullerton Ave Montclair NJ 07042-3411 Ph: (973) 744-7337 | Integrated Medical Associates Llc 48 N Fullerton Ave Montclair NJ 07042-3411 Ph: (973) 744-7337 |
| NPI Number | 1902927874 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 08/13/2012 |
| Medicare PECOS PAC ID | 6305852252 |
|---|---|
| Medicare Enrollment ID | O20060301000532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902927874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | MA69300 (New Jersey) | Primary |
| Provider Name | Rowen G Diano |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1992862585 PECOS PAC ID: 7315917549 Enrollment ID: I20040727000663 |
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