# FAMILY MEDICAL SPECIALIST PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942523105
- **Authorized official:** MR. JOSE LOPEZ (MANAGER)
- **Authorized official phone:** (973) 653-9669

## Contact information

- **Practice address:** 534 21ST AVE, PATERSON, NJ 07513-1337
- **Practice address phone:** (973) 653-9669
- **Mailing address:** 534 21ST AVE, PATERSON, NJ 07513-1337
- **Mailing address phone:** (973) 653-9669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 25MA03169500 | NJ | Yes |

## Other

- **Enumeration date:** 03/02/2010
- **Last updated:** 03/02/2010