Organization
PREVENTION CLINICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGED T BOUTROS MD (OWNER)
(973) 777-3711
Entity
Organization
Contact information
Practice address
1033 ROUTE 46 STE G1, CLIFTON, NJ 07013-2448
(973) 777-3711
(973) 472-3938
Mailing address
1033 ROUTE 46 STE G1, CLIFTON, NJ 07013-2448
(973) 777-3711
(973) 472-3938
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08097300
NJ
261QP2300X
Primary Care Clinic/Center
Primary
25MA08097300
NJ
Other
Enumeration date
09/03/2015
Last updated
07/21/2022
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