Provider Demographics
NPI:1205228566
Name:NORTH JERSEY FAMILY MEDICINE, L.L.C.
Entity type:Organization
Organization Name:NORTH JERSEY FAMILY MEDICINE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:DELA GENTE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-337-3412
Mailing Address - Street 1:19 YAWPO AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2739
Mailing Address - Country:US
Mailing Address - Phone:201-337-3412
Mailing Address - Fax:201-337-3353
Practice Address - Street 1:19 YAWPO AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2739
Practice Address - Country:US
Practice Address - Phone:201-337-3412
Practice Address - Fax:201-337-3353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-24
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07883400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty