Provider Demographics
NPI:1659583706
Name:NEPTUNE INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:NEPTUNE INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NONATO
Authorized Official - Middle Name:ESPIRITU
Authorized Official - Last Name:PINEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-922-1122
Mailing Address - Street 1:3456 W BANGS AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3012
Mailing Address - Country:US
Mailing Address - Phone:732-922-1122
Mailing Address - Fax:
Practice Address - Street 1:3456 W BANGS AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3012
Practice Address - Country:US
Practice Address - Phone:732-922-1122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
093272Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER