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NPI Code Detail

MEDICARE: METROPOLITAN COMMUNITY MEDICAL CARE LLC

MEDICARE: METROPOLITAN COMMUNITY MEDICAL CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center25MA07280100NJ

General Provider Information

NPI Number : 1164615126
Entity Type Code : Organization
Provider Name (Legal Business Name) : METROPOLITAN COMMUNITY MEDICAL CARE LLC
Provider Business Mailing Address
First Line : 500 WESTFIELD AVE
Second Line :
City : ELIZABETH
State : NJ
Zip : 07208-1642
Country : US
Telephone Number : 908-994-1500
Fax Number : 908-994-0035
Provider Business Practice Location Address
First Line : 500 WESTFIELD AVE
Second Line :
City : ELIZABETH
State : NJ
Zip : 07208-1642
Country : US
Telephone Number : 908-994-1500
Fax Number : 908-994-0035
Authorized Official
Title or Position : PHYSICIAN ASSISTANT
Name : MR. EDWARD RAKLER
Credential : PA-C
Telephone Number : 908-994-1500
Provider Enumeration Date : 08/23/2007
Last Update Date : 10/08/2010

Similar Medicare Providers

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1811290778 — MS. STELLA OLSON LCSW
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Directions to “METROPOLITAN COMMUNITY MEDICAL CARE LLC ” Practice Location

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