Organization
PARK AVE MEDICAL CENTRE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFATH K HUMERA MD (SOLE PROPREITER)
(862) 239-4808
Entity
Organization
Contact information
Practice address
535 GETTY AVE, SUITE 3, CLIFTON, NJ 07011-2105
(862) 239-4808
Mailing address
1367 RATZER RD, WAYNE, NJ 07470-2429
(862) 239-4808
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA08760600
NJ
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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