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)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
Provider Address
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