| Prevention Clinics Llc | |
|
1033 Route 46 Ste G1 Clifton NJ 07013-2448 | |
| (973) 777-3711 | |
| (973) 472-3938 |
| Full Name | Prevention Clinics Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1033 Route 46 Ste G1, Clifton, New Jersey |
| Authorized Official Name and Position | Maged T Boutros (OWNER) |
| Authorized Official Contact | 9737773711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prevention Clinics Llc 1033 Route 46 Ste G1 Clifton NJ 07013-2448 Ph: (973) 777-3711 | Prevention Clinics Llc 1033 Route 46 Ste G1 Clifton NJ 07013-2448 Ph: (973) 777-3711 |
| NPI Number | 1073981361 |
|---|---|
| Provider Enumeration Date | 09/03/2015 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 3173830445 |
|---|---|
| Medicare Enrollment ID | O20150918000897 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073981361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA08097300 (New Jersey) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 25MA08097300 (New Jersey) | Primary |
| Provider Name | Maged Boutros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497785281 PECOS PAC ID: 7214931005 Enrollment ID: I20060911000083 |
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