| T.A.E.L.L.C. | |
|
450 University Ct Brick NJ 08723-6007 | |
| (732) 262-3001 | |
| (732) 262-3011 |
| Full Name | T.A.E.L.L.C. |
|---|---|
| Speciality | Internal Medicine |
| Location | 450 University Ct, Brick, New Jersey |
| Authorized Official Name and Position | Tiberiu A. Gross (M.D.) |
| Authorized Official Contact | 7322623001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| T.A.E.L.L.C. 450 University Ct Brick NJ 08723-6007 Ph: (732) 262-3001 | T.A.E.L.L.C. 450 University Ct Brick NJ 08723-6007 Ph: (732) 262-3001 |
| NPI Number | 1558430546 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3072616325 |
|---|---|
| Medicare Enrollment ID | O20070307000421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558430546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Tiberiu a Gross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366478844 PECOS PAC ID: 8123062411 Enrollment ID: I20050617000042 |
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