Provider Demographics
NPI:1417967456
Name:METROPOLITAN FAMILY HEALTH NETWORK,INC
Entity Type:Organization
Organization Name:METROPOLITAN FAMILY HEALTH NETWORK,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:BEATY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-946-6456
Mailing Address - Street 1:935 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2731
Mailing Address - Country:US
Mailing Address - Phone:201-478-5800
Mailing Address - Fax:201-478-5814
Practice Address - Street 1:935 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2731
Practice Address - Country:US
Practice Address - Phone:201-478-5800
Practice Address - Fax:201-478-5814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24089261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ122883Medicare PIN