Provider Demographics
NPI:1093041030
Name:FAITH FAMILY HEALTH CARE PROFESSIONAL CORP.
Entity Type:Organization
Organization Name:FAITH FAMILY HEALTH CARE PROFESSIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CMO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:JUSTINE
Authorized Official - Last Name:BIROTTE SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-822-9700
Mailing Address - Street 1:43-45 PEARL STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-1166
Mailing Address - Country:US
Mailing Address - Phone:908-822-9700
Mailing Address - Fax:908-822-9701
Practice Address - Street 1:43-45 PEARL STREET
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-1166
Practice Address - Country:US
Practice Address - Phone:908-822-9700
Practice Address - Fax:908-822-9701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service