| Osteopathic Family Medicine Of Northern Nj Llc | |
|
541 Cedar Hill Ave Wyckoff NJ 07481-2150 | |
| (551) 500-5708 | |
| Not Available |
| Full Name | Osteopathic Family Medicine Of Northern Nj Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 541 Cedar Hill Ave, Wyckoff, New Jersey |
| Authorized Official Name and Position | Daniel Defeo (PHYSICIAN OWNER) |
| Authorized Official Contact | 5518151000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Osteopathic Family Medicine Of Northern Nj Llc 541 Cedar Hill Ave Ste 2 Wyckoff NJ 07481-2133 Ph: (551) 815-1000 | Osteopathic Family Medicine Of Northern Nj Llc 541 Cedar Hill Ave Wyckoff NJ 07481-2150 Ph: (551) 500-5708 |
| NPI Number | 1053062539 |
|---|---|
| Provider Enumeration Date | 01/16/2022 |
| Last Update Date | 12/14/2022 |
| Medicare PECOS PAC ID | 6507246550 |
|---|---|
| Medicare Enrollment ID | O20220707003177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053062539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel S De Feo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912147166 PECOS PAC ID: 2668640624 Enrollment ID: I20130904000817 |
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