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Organization

ENGLEWOOD FAMILY HEALTH CENTER, P.A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DIANA M PORTILLA M.D. (MEDICAL DIRECTOR)
(201) 926-1828
Entity
Organization

Contact information

Practice address
148 ENGLE ST, ENGLEWOOD, NJ 07631-2581
(201) 569-1530
(201) 569-6022
Mailing address
148 ENGLE STREET, SUITE NUMBER 1, ENGLEWOOD, NJ 07631-2581
(201) 569-1530
(201) 569-6022

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0611859
NJ
01
G11493
UPIN
NJ
Enumeration date
10/10/2008
Last updated
05/10/2023
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