Provider Demographics
NPI:1215130547
Name:VERA MEDICAL PC
Entity type:Organization
Organization Name:VERA MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GELFAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-483-2223
Mailing Address - Street 1:40 DANA PL
Mailing Address - Street 2:
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624-1019
Mailing Address - Country:US
Mailing Address - Phone:646-483-2223
Mailing Address - Fax:
Practice Address - Street 1:40 DANA PL
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-1019
Practice Address - Country:US
Practice Address - Phone:646-483-2223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07106600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty