Provider Demographics
NPI:1316005101
Name:UNION FAMILY MEDICINE
Entity Type:Organization
Organization Name:UNION FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:908-688-4424
Mailing Address - Street 1:2300 VAUXHALL ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083
Mailing Address - Country:US
Mailing Address - Phone:908-688-4424
Mailing Address - Fax:908-688-4832
Practice Address - Street 1:2300 VAUXHALL ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-688-4424
Practice Address - Fax:908-688-4832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB070080207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH14516Medicare UPIN