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General NPI Number Information
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NPI Number | 1437185683
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICAL CARE OF CLIFTON, LLC
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 1033 CLIFTON AVE 2ND FLOOR
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City | CLIFTON
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State | NJ
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Zip | 07013-3517
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Country | US
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Telephone | 973-470-8377
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Fax | 973-470-8534
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Provider Business Mailing Address
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Address Line | 1033 CLIFTON AVE 2ND FLOOR
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City | CLIFTON
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State | NJ
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Zip | 07013-3517
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Country | US
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Telephone | 973-470-8377
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Fax | 973-470-8534
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DAVID CHEN
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Credential | M.D
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Telephone | 973-470-8377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MA0780960
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MA07723400
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License Number State | NJ
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