| Taylors Mills Family Medical Pc | |
|
224 Taylors Mills Road Manalapan NJ 07726 | |
| (732) 577-1066 | |
| (732) 577-0049 |
| Full Name | Taylors Mills Family Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 224 Taylors Mills Road, Manalapan, New Jersey |
| Authorized Official Name and Position | Alexander Goldberg (PHYSICIAN) |
| Authorized Official Contact | 7325771066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Taylors Mills Family Medical Pc 11 Amagansett Dr Morganville NJ 07751-1182 Ph: (732) 995-9760 | Taylors Mills Family Medical Pc 224 Taylors Mills Road Manalapan NJ 07726 Ph: (732) 577-1066 |
| NPI Number | 1043348865 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 04/07/2010 |
| Medicare PECOS PAC ID | 6901066505 |
|---|---|
| Medicare Enrollment ID | O20120319000505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043348865 | NPI | - | NPPES |
| 9017003 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MA61632 (New Jersey) | Primary |
| Provider Name | Alexander Goldberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952371734 PECOS PAC ID: 5890955496 Enrollment ID: I20120319000557 |
| Provider Name | Lucy Rivilis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225471568 PECOS PAC ID: 7012157951 Enrollment ID: I20130717000297 |
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