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Organization
FAMILY LEGACY MEDICAL CARE, PA
Active
Organization
FAMILY LEGACY MEDICAL CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PASCALE FERDINAND MD (PHYSICIAN)
(908) 351-6663
Entity
Organization
Contact information
Practice address
115 JEFFERSON AVE, ELIZABETH, NJ 07201-2417
(908) 351-6663
(908) 351-1760
Mailing address
115 JEFFERSON AVE, ELIZABETH, NJ 07201-2417
(908) 351-6663
(908) 351-1760
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10655985
CAQH
NJ
01
—
14126510
CAQH
NJ
Enumeration date
06/15/2018
Last updated
01/19/2019
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