Provider Demographics
NPI:1851483481
Name:FAMILIES FIRST HEALTHCARE, LLC.
Entity Type:Organization
Organization Name:FAMILIES FIRST HEALTHCARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:D
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-727-0999
Mailing Address - Street 1:701 E MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3032
Mailing Address - Country:US
Mailing Address - Phone:856-727-0999
Mailing Address - Fax:856-727-7997
Practice Address - Street 1:701 E MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3032
Practice Address - Country:US
Practice Address - Phone:856-727-0999
Practice Address - Fax:856-727-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06096900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7270208Medicaid
NJPE820275Medicare ID - Type Unspecified
NJG19765Medicare UPIN