| Primary Care Medical Group Pa | |
|
450 Bergen St Harrison NJ 07029-2291 | |
| (973) 484-6900 | |
| (973) 484-0029 |
| Full Name | Primary Care Medical Group Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 450 Bergen St, Harrison, New Jersey |
| Authorized Official Name and Position | Ralph S D'agostino (OWNER) |
| Authorized Official Contact | 9734846900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Medical Group Pa 450 Bergen St Harrison NJ 07029-2291 Ph: (973) 484-6900 | Primary Care Medical Group Pa 450 Bergen St Harrison NJ 07029-2291 Ph: (973) 484-6900 |
| NPI Number | 1134386410 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 06/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134386410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 31348 (New Jersey) | Primary |