NPI 1205531688

Elite Premier Medical Care Plus LLC.

Organisation Family Medicine Physician Fair Lawn, NJ

Practice location

Address: 15-01 Broadway, Fair Lawn, NJ 07410-6003
Phone: (201) 773-4200

Authorised official

Name: Fred Revoredo
Title: MD
Phone: (201) 509-3903

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in New Jersey →

Registry record

NPI: 1205531688
Entity type: Organization
NPI issued: 4 Apr 2023
Record last updated: 29 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.