| Family Practice Of Central Jersey | |
|
17 Broad St Freehold NJ 07728-1703 | |
| (732) 462-9622 | |
| (732) 780-0014 |
| Full Name | Family Practice Of Central Jersey |
|---|---|
| Speciality | Family Medicine |
| Location | 17 Broad St, Freehold, New Jersey |
| Authorized Official Name and Position | Kenneth W Faistl (OWNER) |
| Authorized Official Contact | 7324629622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice Of Central Jersey 17 Broad St Freehold NJ 07728-1703 Ph: (732) 462-9622 | Family Practice Of Central Jersey 17 Broad St Freehold NJ 07728-1703 Ph: (732) 462-9622 |
| NPI Number | 1942277223 |
|---|---|
| Provider Enumeration Date | 03/04/2006 |
| Last Update Date | 05/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942277223 | NPI | - | NPPES |
| 7461402 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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