Organization · NPI-2

Om Medical Center LLC.

Clinic/Center · Fair Lawn, NJ

NPI number1346346103
StatusActive
Last updated in NPPESJun 8, 2010

Details

NPI
1346346103
Entity type
Organization (NPI-2)
Legal business name
Om Medical Center LLC.
Organization subpart
No
Enumeration date
Sep 16, 2006
Last updated
Jun 8, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

12-15 Broadway Ste B
Fair Lawn, NJ 07410-2031

Phone 201-773-6868 · Fax 201-773-6867

Mailing address

12-15 Broadway Ste B
Fair Lawn, NJ 07410-2031

Phone 201-773-6868 · Fax 201-773-6867

Authorized official

Dushyant R Patel
Doctor Owner
2017736868

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