Provider Demographics
NPI:1295919959
Name:AC FAMILY MEDICAL PHYSICIANS
Entity type:Organization
Organization Name:AC FAMILY MEDICAL PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NIGALAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-348-2211
Mailing Address - Street 1:1 S NEW YORK AVE
Mailing Address - Street 2:SUITE 512
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-8012
Mailing Address - Country:US
Mailing Address - Phone:609-348-2211
Mailing Address - Fax:609-348-2264
Practice Address - Street 1:1 S NEW YORK AVE
Practice Address - Street 2:SUITE 512
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-8012
Practice Address - Country:US
Practice Address - Phone:609-348-2211
Practice Address - Fax:609-348-2264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC53238Medicare UPIN
NJ488784BR9Medicare PIN