| Nina L. Tubilleja, Md, P.c. | |
|
403 Penn Ave. Forked River NJ 08731-1051 | |
| (609) 971-9392 | |
| Not Available |
| Full Name | Nina L. Tubilleja, Md, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 403 Penn Ave., Forked River, New Jersey |
| Authorized Official Name and Position | Nina Lapidario Tubilleja (PRESIDENT) |
| Authorized Official Contact | 6099719392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nina L. Tubilleja, Md, P.c. 403 Penn Ave. Forked River NJ 08731-1051 Ph: (609) 971-9392 | Nina L. Tubilleja, Md, P.c. 403 Penn Ave. Forked River NJ 08731-1051 Ph: (609) 971-9392 |
| NPI Number | 1205023660 |
|---|---|
| Provider Enumeration Date | 10/01/2007 |
| Last Update Date | 10/01/2007 |
| Medicare PECOS PAC ID | 7012002017 |
|---|---|
| Medicare Enrollment ID | O20071005000465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205023660 | NPI | - | NPPES |
| 8001901 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA06960000 (New Jersey) | Primary |
| Provider Name | Nina L Tubilleja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144291196 PECOS PAC ID: 1456444223 Enrollment ID: I20070910000921 |
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