Organization

Elite Premier Medical Care Llc

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

Legal Business Name

Elite Premier Medical Care Llc

NPI Number

1609144005

NPI Type

Organization

Enumeration Date

12/13/2011

Specialties

(Taxonomies)

Code

207Q00000X

Primary Taxonomy

Yes

Licenses

State

New Jersey

License Number

25MA07147400

Contact
Information

Purpose

Mailing
Location

Address

425 15TH AVE STE 2
470 CHAMBERLAIN AVE STE 7

City

Paterson
Paterson

State

NJ
NJ

Postal Code

07504-1811
07522-1000

Country

US
US

Telephone Number

(973) 595-7400
(973) 595-7400

Authorized Official

Name

Miryam Revoredo

Title or Position

GENERAL MANEGAR

Telephone Number

(973) 595-7400

Identifiers

Identifier

8376808

Identifier State

NJ

Identifier Issuer

Unknown

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

Data last updated by provider on 12/13/2011

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