| Organization Name: | FAMILY PRACTICE CENTER, CORP. |
| NPI Number: | 1497069314 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FERMIN J LEON (OWNER) |
| Mailing Address: | 504 51st St West New York |
| State: | NJ US |
| Postal Code: | 070935503 |
| Phone Number: | 2018638342 |
| Fax Number: | 2018638415 |
| NPI Enumeration Date: | 08/03/2010 |
| NPI Last Update Date: | 08/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 25MA03535900 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |