MEDICARE: INTERNAL MEDICINE & GERIATRIC SPECIALIST OF NORTH JERSEY, 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	25MB07249800	NJ

General Provider Information

NPI Number	:	1538318795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNAL MEDICINE & GERIATRIC SPECIALIST OF NORTH JERSEY, LLC

Provider Business Mailing Address
First Line	:	2811 KENNEDY BLVD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-2227
Country	:	US
Telephone Number	:	201-319-0008
Fax Number	:	201-319-0004

Provider Business Practice Location Address
First Line	:	2811 KENNEDY BLVD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-2227
Country	:	US
Telephone Number	:	201-319-0008
Fax Number	:	201-319-0004

Authorized Official
Title or Position	:	ACCOUNT EXECUTIVE
Name	:	MRS. DEBI SMITH
Credential	:
Telephone Number	:	201-376-0770

Provider Enumeration Date	:	09/11/2008
Last Update Date	:	09/11/2008

Similar Medicare Providers

1396774246 — HUDSON MRI PA
Practice Location Address:

2811 KENNEDY BLVD
NORTH BERGEN, NJ
07047-2227

Practice Phone: 201-659-1177
Practice Fax:

1942546106 — NORTH BERGEN PEDIATRICS
Practice Location Address:

2811 KENNEDY BLVD
NORTH BERGEN, NJ
07047-2227

Practice Phone: 973-458-8000
Practice Fax: 973-458-8425

1003315037 — DR. HARRIS MOORE DC, LLC
Practice Location Address:

2811 KENNEDY BLVD
NORTH BERGEN, NJ
07047-2227

Practice Phone: 201-290-3904
Practice Fax: 201-442-0446

1508052044 — REHAB PROFESSIONALS OF CLEVELAND, INC.
Practice Location Address:

23887 LORAIN RD
NORTH OLMSTED, OH
44070-2227

Practice Phone: 440-777-1764
Practice Fax:

1396174850 — ANDREW DAVIS
Practice Location Address:

6731 SUGARBIRD CT
NORTH LAS VEGAS, NV
89084-2227

Practice Phone: 502-299-5730
Practice Fax: 702-432-6463

1932519568 — KRISTIN MARKS
Practice Location Address:

23887 LORAIN RD
NORTH OLMSTED, OH
44070-2227

Practice Phone: 440-777-1764
Practice Fax:

Directions to “INTERNAL MEDICINE & GERIATRIC SPECIALIST OF NORTH JERSEY, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.