Organization
FAMILY MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESSAM A OTHMAN MD (OWNER/PROPRIETER)
(908) 436-0022
Entity
Organization
Contact information
Practice address
700 N BROAD ST, ELIZABETH, NJ 07208-2310
(908) 436-0022
(908) 436-0088
Mailing address
700 N BROAD ST, ELIZABETH, NJ 07208-2310
(908) 436-0022
(908) 436-0088
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
MA062349
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7077009
—
NJ
Enumeration date
08/27/2014
Last updated
08/27/2014
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