| Vivant Medical Care Pc | |
|
1025 Linden Ave Ridgefield NJ 07657-1006 | |
| (201) 282-7556 | |
| Not Available |
| Full Name | Vivant Medical Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1025 Linden Ave, Ridgefield, New Jersey |
| Authorized Official Name and Position | Samir Khalil (PRESIDENT) |
| Authorized Official Contact | 2012827556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivant Medical Care Pc 1025 Linden Ave Ridgefield NJ 07657-1006 Ph: (201) 282-7556 | Vivant Medical Care Pc 1025 Linden Ave Ridgefield NJ 07657-1006 Ph: (201) 282-7556 |
| NPI Number | 1376209072 |
|---|---|
| Provider Enumeration Date | 11/17/2021 |
| Last Update Date | 11/17/2021 |
| Medicare PECOS PAC ID | 8820484454 |
|---|---|
| Medicare Enrollment ID | O20220408000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376209072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Samir Khalil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396087987 PECOS PAC ID: 5799090833 Enrollment ID: I20201117002027 |
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