| White Oak Professional Llc | |
|
240 Shadyside Rd Ramsey NJ 07446-1718 | |
| (201) 785-7113 | |
| Not Available |
| Full Name | White Oak Professional Llc |
|---|---|
| Speciality | General Practice |
| Location | 240 Shadyside Rd, Ramsey, New Jersey |
| Authorized Official Name and Position | Talitha Burns (OWNER) |
| Authorized Official Contact | 2019533941 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Oak Professional Llc 240 Shadyside Rd Ramsey NJ 07446-1718 Ph: (201) 953-3941 | White Oak Professional Llc 240 Shadyside Rd Ramsey NJ 07446-1718 Ph: (201) 785-7113 |
| NPI Number | 1114509122 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 01/03/2022 |
| Medicare PECOS PAC ID | 3375934243 |
|---|---|
| Medicare Enrollment ID | O20220104000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114509122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Talitha M Burns |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578661856 PECOS PAC ID: 2264430248 Enrollment ID: I20061130000117 |
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