NPI 1942523105

Family Medical Specialist PA

Organisation General Practice Physician Paterson, NJ

Practice location

Address: 534 21st Ave, Paterson, NJ 07513-1337
Phone: (973) 653-9669

Authorised official

Name: Jose Lopez
Title: Manager
Phone: (973) 653-9669

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 25MA03169500 (NJ)

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Registry record

NPI: 1942523105
Entity type: Organization
NPI issued: 2 Mar 2010
Record last updated: 2 Mar 2010

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.