| South Orange Ave Medical Associates Llc | |
|
707 S Orange Ave South Orange NJ 07079-2698 | |
| (973) 761-1140 | |
| (973) 761-4990 |
| Full Name | South Orange Ave Medical Associates Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 707 S Orange Ave, South Orange, New Jersey |
| Authorized Official Name and Position | Ramesh Patel (PRESIDENT) |
| Authorized Official Contact | 9737611140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Orange Ave Medical Associates Llc 707 S Orange Ave South Orange NJ 07079-2698 Ph: (973) 761-1140 | South Orange Ave Medical Associates Llc 707 S Orange Ave South Orange NJ 07079-2698 Ph: (973) 761-1140 |
| NPI Number | 1538432786 |
|---|---|
| Provider Enumeration Date | 02/20/2012 |
| Last Update Date | 02/20/2012 |
| Medicare PECOS PAC ID | 8022272509 |
|---|---|
| Medicare Enrollment ID | O20120613000286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538432786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Dinesh R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285702829 PECOS PAC ID: 9436191962 Enrollment ID: I20050928000381 |
| Provider Name | Ramesh L Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437245354 PECOS PAC ID: 9739104761 Enrollment ID: I20051010000454 |
| Provider Name | John M Augustin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225146632 PECOS PAC ID: 1052447869 Enrollment ID: I20100331000830 |
| Provider Name | Satish R Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366545402 PECOS PAC ID: 2466647797 Enrollment ID: I20101112000483 |
| Provider Name | Neha Bangia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053648311 PECOS PAC ID: 6204024193 Enrollment ID: I20101220000209 |
| Provider Name | Aigner Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669813119 PECOS PAC ID: 9830319805 Enrollment ID: I20140926000148 |
| Provider Name | Chirag D Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1114326162 PECOS PAC ID: 5991003972 Enrollment ID: I20160406002319 |
| Provider Name | Sulakshana Gandhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669819744 PECOS PAC ID: 1153643135 Enrollment ID: I20171129002302 |
| Provider Name | Gurdarshan Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609370089 PECOS PAC ID: 7911390190 Enrollment ID: I20220210002472 |
| Provider Name | Jaimy Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467804625 PECOS PAC ID: 3678959046 Enrollment ID: I20221008000050 |
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