Primary Care Medical Practice, LLC
NPI #1912113002 in Woodland Park, New Jersey
Provider Information
- NPI Number
- 1912113002
- Entity Type
- Organization
- Organization Name
- Primary Care Medical Practice, LLC
- Primary Specialty
- Specialist
- Enumeration Date
- May 15, 2007
- Last Updated
- Jul 1, 2013
Practice Location
- Address
- 1031 MCBRIDE AVE
- Address 2
- SUITE D 205
- City
- Woodland Park
- State
- New Jersey
- ZIP Code
- 07424-2559
- Phone
- (973) 237-9055
Authorized Official
- Name
- DR. SAMUEL ISSAM MALLOUHI, M.D
- Title
- PRESIDENT
- Phone
- (973) 237-9055
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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