Provider Demographics
NPI:1891737227
Name:F & D MEDICAL, LLC
Entity Type:Organization
Organization Name:F & D MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FEI
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-567-0686
Mailing Address - Street 1:385 SYLVAN AVE
Mailing Address - Street 2:25
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2726
Mailing Address - Country:US
Mailing Address - Phone:201-567-0686
Mailing Address - Fax:201-567-2060
Practice Address - Street 1:385 SYLVAN AVE
Practice Address - Street 2:25
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2726
Practice Address - Country:US
Practice Address - Phone:201-567-0686
Practice Address - Fax:201-567-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07007200261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ31D10200389OtherCLIA ID