Healthcare Provider Details

I. General information

NPI: 1891737227
Provider Name (Legal Business Name): F & D MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 SYLVAN AVE 25
ENGLEWOOD CLIFFS NJ
07632-2726
US

IV. Provider business mailing address

385 SYLVAN AVE 25
ENGLEWOOD CLIFFS NJ
07632-2726
US

V. Phone/Fax

Practice location:
  • Phone: 201-567-0686
  • Fax: 201-567-2060
Mailing address:
  • Phone: 201-567-0686
  • Fax: 201-567-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number25MA07007200
License Number StateNJ

VIII. Authorized Official

Name: FEI YU
Title or Position: PRESIDENT
Credential: MD
Phone: 201-567-0686