Organization
FAMILY MEDICAL SPECIALIST PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE LOPEZ (MANAGER)
(973) 653-9669
Entity
Organization
Contact information
Practice address
534 21ST AVE, PATERSON, NJ 07513-1337
(973) 653-9669
Mailing address
534 21ST AVE, PATERSON, NJ 07513-1337
(973) 653-9669
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
25MA03169500
NJ
Other
Enumeration date
03/02/2010
Last updated
03/02/2010
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