Organization
NORTHEAST MEDICAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA JEAN NAKOA (BILLING COORDINATOR)
(610) 997-0779
Entity
Organization
Contact information
Practice address
59 ROSEBERRY ST, PHILLIPSBURG, NJ 08865-1627
(908) 454-8600
(908) 454-3524
Mailing address
59 ROSEBERRY ST, PHILLIPSBURG, NJ 08865-1627
(908) 454-8600
(908) 454-3524
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB3243
RRMEDICARE PIN
NJ
01
—
DF8599
RRMEDICARE PIN
PA
Enumeration date
05/31/2006
Last updated
12/05/2007
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