Provider Demographics
NPI:1578728481
Name:NEW IMAGE MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:NEW IMAGE MEDICAL CENTER, LLC
Other - Org Name:ZORICA J. MERCADANTE, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZORICA
Authorized Official - Middle Name:JELISIJEVIC
Authorized Official - Last Name:MERCADANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-923-1777
Mailing Address - Street 1:103 PARKER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1009
Mailing Address - Country:US
Mailing Address - Phone:732-923-1777
Mailing Address - Fax:732-923-1772
Practice Address - Street 1:103 PARKER RD
Practice Address - Street 2:SUITE B
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1009
Practice Address - Country:US
Practice Address - Phone:732-923-1777
Practice Address - Fax:732-923-1772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68083261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1285614586OtherHORIZON BLUE CROSS BLUE SHIELD
NJP3645629OtherOXFORD
NJ5884631OtherAETNA
NJ7497116OtherCIGNA
NJ1918893OtherUNITED HEALTHCARE
NJG26423Medicare UPIN
NJP3645629OtherOXFORD