Provider Demographics
NPI:1811014202
Name:FAMILY MEDICAL CENTER PC
Entity Type:Organization
Organization Name:FAMILY MEDICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOCHRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-636-6622
Mailing Address - Street 1:1 WOODBRIDGE CTR STE 400
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1159
Mailing Address - Country:US
Mailing Address - Phone:732-636-6622
Mailing Address - Fax:732-636-3669
Practice Address - Street 1:1 WOODBRIDGE CTR STE 400
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1159
Practice Address - Country:US
Practice Address - Phone:732-636-6622
Practice Address - Fax:732-636-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0083787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ672326Medicare ID - Type UnspecifiedMEDICARE ID