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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