PREVENTIVE MEDICINE OF MONMOUTH PC - NPI NUMBER 1598896912
Provider Name: PREVENTIVE MEDICINE OF MONMOUTH PC
NPI Number: 1598896912
Clasification: Family Medicine (207Q00000X)
555 SHREWSBURY AVE
Phone Number: (732) 219-0894
PREVENTIVE MEDICINE OF MONMOUTH PC is a family physician in Shrewsbury, NJ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. The assigned NPI number for this provider is 1598896912 and is registered as an organization entity type and is a single specialty group.
The provider's business address is:
555 SHREWSBURY AVE
Phone: (732) 219-0894
Fax: (732) 219-0896
The provider's authorized official is Neil Rosen .
The authorized official title is President and has the following contact phone number (732) 219-0894.
The enumeration date for this NPI number is 3/8/2007 and was last updated on 10/1/2008.
Map - Location of Practice
||ELAINE BACCI, DO
||TRACI A TAMBURELLO, D.O.
||DR. PRIYA A YELLAYI, M.D.
||VICTORIA TRIOLA, DO
||NEIL L ROSEN, D.O.
||DOMINICK A. GROSSO, D.O. LLC
Family Medicine (Adult Medicine)
||CENTER FOR COGNITIVE REHABILITATION
Family Medicine (Addiction Medicine)
The following information regarding the scope of practice of this provider is available:
Other (Legacy) Identifiers
The following legacy identifiers are available for this provider:
||MEDICARE ID-TYPE UNSPECIFIED
||Entity Type Code
||Employer Identification Number EIN
||Provider Organization Name Legal Business Name
||PREVENTIVE MEDICINE OF MONMOUTH PC
||Provider First Line Business Practice Location Address
||555 SHREWSBURY AVE
||Provider Business Practice Location Address City Name
||Provider Business Practice Location Address State Name
||Provider Business Practice Location Address Postal Code
||Provider Business Practice Location Address Country Code If outside U S
||Provider Business Practice Location Address Telephone Number
||Provider Business Practice Location Address Fax Number
||Provider Enumeration Date
||Last Update Date
||Authorized Official Last Name
||Authorized Official First Name
||Authorized Official Title or Position
||Authorized Official Telephone Number
||Healthcare Provider Taxonomy Code 1
||Healthcare Provider Primary Taxonomy Switch 1
||Other Provider Identifier 1
||Other Provider Identifier Type Code 1
||Other Provider Identifier State 1
||Is Organization Subpart
||Authorized Official Credential Text
||Healthcare Provider Taxonomy Group 1
||193400000X SINGLE SPECIALTY GROUP
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This page was last updated on: 1/13/2015
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