Organization · NPI-2

Elite Premier Medical Care LLC

Family Medicine · Paterson, NJ

NPI number1609144005
StatusActive
Last updated in NPPESDec 13, 2011

Details

NPI
1609144005
Entity type
Organization (NPI-2)
Legal business name
Elite Premier Medical Care LLC
Organization subpart
No
Enumeration date
Dec 13, 2011
Last updated
Dec 13, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine25MA07147400NJYes

Practice location

470 Chamberlain Ave Ste 7
Paterson, NJ 07522-1000

Phone 973-595-7400

Mailing address

425 15th Ave Ste 2
Paterson, NJ 07504-1811

Phone 973-595-7400 · Fax 973-345-4156

Authorized official

Miryam Revoredo
General Manegar
9735957400

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