| Elite Premier Medical Care Llc | |
|
470 Chamberlain Ave Ste 7 Paterson NJ 07522-1000 | |
| (973) 595-7400 | |
| Not Available |
| Full Name | Elite Premier Medical Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 470 Chamberlain Ave Ste 7, Paterson, New Jersey |
| Authorized Official Name and Position | Miryam Revoredo (GENERAL MANEGAR) |
| Authorized Official Contact | 9735957400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Premier Medical Care Llc 425 15th Ave Ste 2 Paterson NJ 07504-1811 Ph: (973) 595-7400 | Elite Premier Medical Care Llc 470 Chamberlain Ave Ste 7 Paterson NJ 07522-1000 Ph: (973) 595-7400 |
| NPI Number | 1609144005 |
|---|---|
| Provider Enumeration Date | 12/13/2011 |
| Last Update Date | 12/13/2011 |
| Medicare PECOS PAC ID | 3274795463 |
|---|---|
| Medicare Enrollment ID | O20120504000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609144005 | NPI | - | NPPES |
| 8376808 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA07147400 (New Jersey) | Primary |
| Provider Name | Fred S Revoredo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669588422 PECOS PAC ID: 3779479480 Enrollment ID: I20040227000314 |
Challenge Program Of New Jersey Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 152 Market St, Suite 200, Paterson, NJ 07505 Phone: 973-345-9100 Fax: 973-345-9110 | |
Community Health Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 540 Straight St Ste 2c, Paterson, NJ 07503 Phone: 862-657-5500 Fax: 862-657-5501 | |
Omar T Cockey Dmd Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 703 Main St, Paterson, NJ 07503 Phone: 973-779-6183 Fax: 973-779-6183 | |
Family Care Of New Jersey Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1042 Main St, Paterson, NJ 07503 Phone: 973-510-2444 Fax: 973-278-2818 | |
Vance Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 703 Main St, Paterson, NJ 07503 Phone: 973-754-2000 | |
Paterson Community Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 32 Clinton St, Paterson, NJ 07522 Phone: 973-790-6594 Fax: 973-790-7703 | |
Fidelis Medical Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1042 Main St, Paterson, NJ 07503 Phone: 973-510-2444 Fax: 973-278-2818 |