Organization · NPI-2

Fidelis Medical Group LLC

Family Medicine · Paterson, NJ

NPI number1093409310
StatusActive
Last updated in NPPESJun 8, 2023

Details

NPI
1093409310
Entity type
Organization (NPI-2)
Legal business name
Fidelis Medical Group LLC
Organization subpart
No
Enumeration date
Jun 8, 2023
Certification date
Jun 8, 2023
Last updated
Jun 8, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
207R00000X Internal Medicine––

Practice location

1042 Main St
Paterson, NJ 07503-2212

Phone 973-510-2444 · Fax 973-278-2818

Mailing address

101 Crawfords Corner Rd Ste 1014r
Holmdel, NJ 07733-1976

Phone 605-915-3202

Other practice locations

1044 Main St
Paterson, NJ 07503-2212

Phone 973-988-3000

Authorized official

Aijuan Wang
Medical Director
7322216870

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