Provider Demographics
NPI:1336491976
Name:ALL TOTAL HEALTH CARE
Entity Type:Organization
Organization Name:ALL TOTAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGED
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUTROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1917-618-4446
Mailing Address - Street 1:51 S PARK ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2735
Mailing Address - Country:US
Mailing Address - Phone:191-761-8444
Mailing Address - Fax:888-627-3079
Practice Address - Street 1:51 S PARK ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2735
Practice Address - Country:US
Practice Address - Phone:191-761-8444
Practice Address - Fax:888-627-3079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08097300261QP2300X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care