Provider Demographics
NPI:1235361833
Name:FIRST CARE MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:FIRST CARE MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:AMBROSIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-857-8995
Mailing Address - Street 1:750 VALLEY BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1301
Mailing Address - Country:US
Mailing Address - Phone:201-896-0900
Mailing Address - Fax:201-896-2726
Practice Address - Street 1:750 VALLEY BROOK AVE
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-1301
Practice Address - Country:US
Practice Address - Phone:201-896-0900
Practice Address - Fax:201-896-2726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty