| Shore Medicine Llc | |
|
1255 Highway 70 Suite 24-s Lakewood NJ 08701-5900 | |
| (732) 730-0020 | |
| (732) 730-0035 |
| Full Name | Shore Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1255 Highway 70, Lakewood, New Jersey |
| Authorized Official Name and Position | Manjula Thopcherla (PRESIDENT) |
| Authorized Official Contact | 7327300020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Medicine Llc 1255 Highway 70 Suite 24-s Lakewood NJ 08701-5900 Ph: (732) 730-0020 | Shore Medicine Llc 1255 Highway 70 Suite 24-s Lakewood NJ 08701-5900 Ph: (732) 730-0020 |
| NPI Number | 1972638039 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 10/26/2007 |
| Medicare PECOS PAC ID | 2961419627 |
|---|---|
| Medicare Enrollment ID | O20060321000624 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972638039 | NPI | - | NPPES |
| DE4170 | Other | NJ | PALMETTO GBA RAILROAD MED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Manjula Thopcherla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598782930 PECOS PAC ID: 5395760136 Enrollment ID: I20051011000719 |
| Provider Name | Kim F Whalen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568407112 PECOS PAC ID: 8527248871 Enrollment ID: I20110203001061 |
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