MEDICARE: LINWOOD INTERNAL MEDICINE CORP

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1225705775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINWOOD INTERNAL MEDICINE CORP

Provider Business Mailing Address
First Line	:	524 MAPLE AVE
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1213
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	524 MAPLE AVE
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1213
Country	:	US
Telephone Number	:	609-412-9864
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GRACE FIORENTINO
Credential	:
Telephone Number	:	609-204-5247

Provider Enumeration Date	:	08/24/2021
Last Update Date	:	08/24/2021

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Directions to “LINWOOD INTERNAL MEDICINE CORP ” Practice Location

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