| On-site Medical Group Pc | |
|
50 Us Highway 9 North, Suite 102 Grosso Office Park Morganville NJ 07751-1558 | |
| (732) 580-0660 | |
| Not Available |
| Full Name | On-site Medical Group Pc |
|---|---|
| Speciality | Radiology |
| Location | 50 Us Highway 9 North, Suite 102, Morganville, New Jersey |
| Authorized Official Name and Position | Svetlana Bakshiyeva (MANAGING) |
| Authorized Official Contact | 7325800660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| On-site Medical Group Pc 50 Us Highway 9 North, Suite 108 Grosso Office Park Morganville NJ 07751-1558 Ph: () - | On-site Medical Group Pc 50 Us Highway 9 North, Suite 102 Grosso Office Park Morganville NJ 07751-1558 Ph: (732) 580-0660 |
| NPI Number | 1326301185 |
|---|---|
| Provider Enumeration Date | 06/18/2012 |
| Last Update Date | 03/01/2019 |
| Medicare PECOS PAC ID | 2769715374 |
|---|---|
| Medicare Enrollment ID | O20190613003084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326301185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 2085R0204X | Radiology - Vascular & Interventional Radiology | (* (Not Available)) | Primary |
| Provider Name | Douglas T Gibbens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447247382 PECOS PAC ID: 9436144292 Enrollment ID: I20040510000564 |
| Provider Name | Vladimir Rukshin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760716542 PECOS PAC ID: 8628193448 Enrollment ID: I20100917000114 |
| Provider Name | Terrance Lee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053350389 PECOS PAC ID: 1254389091 Enrollment ID: I20110118001180 |
| Provider Name | Anne M Glaser |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689671828 PECOS PAC ID: 3870583321 Enrollment ID: I20110226000042 |
| Provider Name | Daniel Saurborn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578548822 PECOS PAC ID: 5799682100 Enrollment ID: I20150205000796 |
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