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General NPI Number Information
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NPI Number | 1225221989
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Entity Type | Organization
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Legal Business Name | FAMILY CARE,P.A.
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/24/2007
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Provider Practice Location Address
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Address Line | 257 ROUTE 22 E
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City | GREEN BROOK
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State | NJ
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Zip | 08812
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Country | US
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Telephone | 732-968-7878
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Fax | 732-968-7557
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Provider Business Mailing Address
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Address Line | 257 ROUTE 22 E
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City | GREEN BROOK
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State | NJ
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Zip | 08812
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Country | US
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Telephone | 732-968-7878
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Fax | 732-968-7557
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. JOHN CHAFOS
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Credential | M.D
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Telephone | 732-968-7878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 25MA08174900
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License Number State | NJ
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