100 Main Medical Associates
NPI #1619378239 in Paterson, New Jersey
Provider Information
- NPI Number
- 1619378239
- Entity Type
- Organization
- Organization Name
- 100 Main Medical Associates
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Sep 15, 2014
- Last Updated
- Sep 15, 2014
Practice Location
- Address
- 100 MAIN ST
- City
- Paterson
- State
- New Jersey
- ZIP Code
- 07505-1024
- Phone
- (973) 523-0317
Authorized Official
- Name
- DR. LOWELL TACLOB, MD
- Title
- PRESIDENT
- Phone
- (973) 523-0317
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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