Provider Demographics
NPI:1922137819
Name:ATCO MEDICAL ASSOCIATES, PC DBA 1ST CARE MEDICAL ARTS
Entity Type:Organization
Organization Name:ATCO MEDICAL ASSOCIATES, PC DBA 1ST CARE MEDICAL ARTS
Other - Org Name:1ST CARE MEDICAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-767-2000
Mailing Address - Street 1:PO BOX 1683
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012
Mailing Address - Country:US
Mailing Address - Phone:856-767-2000
Mailing Address - Fax:856-767-0073
Practice Address - Street 1:299 S ROUTE 73 STE A
Practice Address - Street 2:
Practice Address - City:WEST BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08091-3702
Practice Address - Country:US
Practice Address - Phone:856-767-2000
Practice Address - Fax:856-767-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD067354207R00000X, 207R00000X
207LP2900X, 207Q00000X
NJ25MA07445800208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0129364Medicaid
NJ117661Medicare PIN