Organization
CENTER FOR ADULT MEDICINE AND PREVENTIVE CARE, PC
Active
Organization
CENTER FOR ADULT MEDICINE AND PREVENTIVE CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS ALBERTO TEJEDA M.D. (MEDICAL DIRECTOR)
(718) 704-8983
Entity
Organization
Contact information
Practice address
916-922 MAIN AVE, SUITE 1A, PASSAIC, NJ 07055-8544
(973) 773-0334
(973) 773-0336
Mailing address
916-922 MAIN AVE, SUITE 1A, PASSAIC, NJ 07055-8544
(973) 773-0334
(973) 773-0336
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135720
MEDICARE PTAN
NJ
Enumeration date
08/02/2008
Last updated
09/15/2016
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