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NPI Code Detail

MEDICARE: CLINICA HEALTH GROUP LLC

MEDICARE: CLINICA HEALTH GROUP 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 PhysicianMA32619NJ

General Provider Information

NPI Number : 1952547333
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICA HEALTH GROUP LLC
Provider Business Mailing Address
First Line : 7511 BERGENLINE AVE
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-5459
Country : US
Telephone Number : 201-868-0021
Fax Number :
Provider Business Practice Location Address
First Line : 7511 BERGENLINE AVE
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-5459
Country : US
Telephone Number : 201-868-0021
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : MR. MICHAEL NERSESIAN
Credential :
Telephone Number : 201-868-0021
Provider Enumeration Date : 01/06/2009
Last Update Date : 01/06/2009

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Directions to “CLINICA HEALTH GROUP LLC ” Practice Location

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