Revoredo Medical Affiliates Llc
Family Medicine Physician in Paterson, NJ(View on Map)
Legal Business Name
Revoredo Medical Affiliates Llc
NPI Number
1881927358
NPI Type
Organization
Enumeration Date
09/15/2009
Specialties
(Taxonomies)Code
207Q00000X
207P00000X
Primary Taxonomy
Yes
No
Licenses
State
New Jersey
License Number
25MA07147400
Contact
Information
Purpose
Mailing
Location
Address
425 15TH AVE
425 15TH AVE
City
Paterson
Paterson
State
NJ
NJ
Postal Code
07504-1811
07504-1811
Country
US
US
Telephone Number
(973) 345-4024
(973) 345-4024
Authorized Official
Name
Dr. Fred Revoredo
Title or Position
PRESIDENT
Telephone Number
(973) 345-4024
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/15/2009
Provider Address
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