Organization
ELENSA MEDICAL II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN ANTONIO SABIDO M.D. (OWNER)
(973) 977-8105
Entity
Organization
Contact information
Practice address
635 BROADWAY, 2ND FLOOR, PATERSON, NJ 07514-1992
(973) 977-8105
(973) 977-8106
Mailing address
1085 FRANKLIN LAKES ROAD, FRANKLIN LAKES, NJ 07417-1131
(973) 977-8105
(973) 977-8106
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
25MA07696900
NJ
261QP2300X
Primary Care Clinic/Center
25MA07696900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203521
—
NJ
Enumeration date
04/15/2009
Last updated
11/01/2012
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