Provider Demographics
NPI:1245426311
Name:CENTER FOR FAMILY MEDICINE,PA
Entity Type:Organization
Organization Name:CENTER FOR FAMILY MEDICINE,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-246-0291
Mailing Address - Street 1:2 TOWER CENTER BLVD FL 12
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1100
Mailing Address - Country:US
Mailing Address - Phone:732-246-0291
Mailing Address - Fax:732-828-0542
Practice Address - Street 1:69 COUNTY RD 516
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1416
Practice Address - Country:US
Practice Address - Phone:732-254-1515
Practice Address - Fax:732-651-0774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty