Provider Demographics
NPI:1811043904
Name:FIRSTMED FAMILY HEALTHCARE LLC
Entity Type:Organization
Organization Name:FIRSTMED FAMILY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:V
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-768-1200
Mailing Address - Street 1:244 LIVINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:NORTHVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07647-1996
Mailing Address - Country:US
Mailing Address - Phone:201-768-1200
Mailing Address - Fax:201-768-4569
Practice Address - Street 1:244 LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:NORTHVALE
Practice Address - State:NJ
Practice Address - Zip Code:07647-1996
Practice Address - Country:US
Practice Address - Phone:201-768-1200
Practice Address - Fax:201-768-4569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 70988207Q00000X
NJMA 71232208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091126Medicare ID - Type UnspecifiedPROVIDER NUMBER