Organization
ADVANCED CARE INTERNAL MEDICINE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE NICOLAS FUENTES M.D. (PRESIDENT)
(973) 900-0471
Entity
Organization
Contact information
Practice address
751 GARNET LN, EAST STROUDSBURG, PA 18301-8495
(973) 900-0471
(570) 730-4415
Mailing address
751 GARNET LN, EAST STROUDSBURG, PA 18301-8495
(973) 900-0471
(570) 730-4415
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA060596
NJ
Other
Enumeration date
12/14/2006
Last updated
04/05/2013
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