| Promed Preferred Nj 2 Pc | |
|
125 Madison St Boonton NJ 07005-2153 | |
| (844) 776-6332 | |
| Not Available |
| Full Name | Promed Preferred Nj 2 Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 125 Madison St, Boonton, New Jersey |
| Authorized Official Name and Position | Lev Grinman (CO-OWNER) |
| Authorized Official Contact | 6466731660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Promed Preferred Nj 2 Pc 4 Legends Cir Melville NY 11747-5302 Ph: () - | Promed Preferred Nj 2 Pc 125 Madison St Boonton NJ 07005-2153 Ph: (844) 776-6332 |
| NPI Number | 1942075346 |
|---|---|
| Provider Enumeration Date | 11/16/2023 |
| Last Update Date | 08/07/2025 |
| Medicare PECOS PAC ID | 0244678522 |
|---|---|
| Medicare Enrollment ID | O20240405000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942075346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gary J Larocca |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1922177922 PECOS PAC ID: 0648232231 Enrollment ID: I20041027000093 |
| Provider Name | Kristen M Denaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518447549 PECOS PAC ID: 6406100965 Enrollment ID: I20181120000329 |
| Provider Name | Puja Bhagat |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1558915181 PECOS PAC ID: 8527397835 Enrollment ID: I20190912000586 |
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