Organization

21st Avenue Primary Care Pa

Family Medicine Physician in Paterson, NJ(View on Map)

Legal Business Name

21st Avenue Primary Care Pa

NPI Number

1609163716

NPI Type

Organization

Enumeration Date

07/09/2011

Specialties

(Taxonomies)

Code

207Q00000X

Primary Taxonomy

Yes

Licenses

State

New Jersey

License Number

25MA05907400

Contact
Information

Purpose

Mailing
Location

Address

534 21ST AVE
534 21ST AVE

City

Paterson
Paterson

State

NJ
NJ

Postal Code

07513-1337
07513-1337

Country

US
US

Telephone Number

(973) 925-5400
(973) 925-5400

Authorized Official

Name

Hector Leon-wong

Title or Position

OWNER/MEDICAL DIRECTOR

Telephone Number

(973) 925-5400

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/09/2011

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