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NPI Code Detail

MEDICARE: MEDCOM HEALTH SERVICES, LLC

MEDICARE: MEDCOM HEALTH SERVICES, 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
1207RC0000XCardiovascular Disease Physician

Other Identifiers

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

General Provider Information

NPI Number : 1881844041
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDCOM HEALTH SERVICES, LLC
Provider Business Mailing Address
First Line : 258 N NEW RD
Second Line :
City : PLEASANTVILLE
State : NJ
Zip : 08232-2170
Country : US
Telephone Number : 609-646-4064
Fax Number :
Provider Business Practice Location Address
First Line : 258 N NEW RD
Second Line :
City : PLEASANTVILLE
State : NJ
Zip : 08232-2170
Country : US
Telephone Number : 609-646-4064
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ILYAS RAJPUT
Credential : MD
Telephone Number : 609-646-4064
Provider Enumeration Date : 09/24/2008
Last Update Date : 09/24/2008

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Directions to “MEDCOM HEALTH SERVICES, LLC ” Practice Location

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