Provider Demographics
NPI:1497404263
Name:CONVENIENT CARE CENTER
Entity Type:Organization
Organization Name:CONVENIENT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOUSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIBDIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-766-1541
Mailing Address - Street 1:57 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-4041
Mailing Address - Country:US
Mailing Address - Phone:862-591-1195
Mailing Address - Fax:201-595-0290
Practice Address - Street 1:57 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-4041
Practice Address - Country:US
Practice Address - Phone:862-591-1195
Practice Address - Fax:201-595-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty