Organization
ELITE PREMIER MEDICAL CARE PLUS LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED REVOREDO MD (MD)
(201) 509-3903
Entity
Organization
Contact information
Practice address
15-01 BROADWAY, FAIR LAWN, NJ 07410-6003
(201) 773-4200
Mailing address
15-01 BROADWAY, FAIR LAWN, NJ 07410-6003
(201) 773-4200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/04/2023
Last updated
07/29/2024
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