Provider Demographics
NPI:1851772974
Name:COMPLETE CARE MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:COMPLETE CARE MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FALLON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-322-6611
Mailing Address - Street 1:1814 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1751
Mailing Address - Country:US
Mailing Address - Phone:908-322-6611
Mailing Address - Fax:908-226-3001
Practice Address - Street 1:1814 E 2ND ST
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1751
Practice Address - Country:US
Practice Address - Phone:908-322-6611
Practice Address - Fax:908-226-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA60650208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty