| New Providence Family Practice Corporation | |
|
139 South St Suite 201 New Providence NJ 07974-1999 | |
| (908) 771-9311 | |
| (908) 771-9302 |
| Full Name | New Providence Family Practice Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 139 South St, New Providence, New Jersey |
| Authorized Official Name and Position | Lorenzo Giovanni Martinetti (PRESIDENT) |
| Authorized Official Contact | 9087719311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Providence Family Practice Corporation 139 South St Suite 201 New Providence NJ 07974-1999 Ph: (908) 771-9311 | New Providence Family Practice Corporation 139 South St Suite 201 New Providence NJ 07974-1999 Ph: (908) 771-9311 |
| NPI Number | 1053670216 |
|---|---|
| Provider Enumeration Date | 05/09/2012 |
| Last Update Date | 05/09/2012 |
| Medicare PECOS PAC ID | 4385809839 |
|---|---|
| Medicare Enrollment ID | O20120706000451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053670216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA04919800 (New Jersey) | Primary |
| Provider Name | Lorenzo Giovanni Martinetti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588722318 PECOS PAC ID: 5294990743 Enrollment ID: I20120706000467 |
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