MEDICARE: N. MURILLO COMPLETE MEDICAL CENTER, 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
1	207R00000X	Internal Medicine Physician	MA72585	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457396665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	N. MURILLO COMPLETE MEDICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	463 CLIFTON AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07011-3227
Country	:	US
Telephone Number	:	973-546-2400
Fax Number	:	973-546-2441

Provider Business Practice Location Address
First Line	:	463 CLIFTON AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07011-3227
Country	:	US
Telephone Number	:	973-546-2400
Fax Number	:	973-546-2441

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NARCISA MURILLO
Credential	:	MD
Telephone Number	:	973-546-2400

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	05/07/2008

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