| Organization Name: | MY FAMILY PRACTICE ASSOCIATES |
| NPI Number: | 1629224233 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MOHAMMED NASIR KHAN (PARTNER) |
| Mailing Address: | 17 S Main St 2 Manville |
| State: | NJ US |
| Postal Code: | 088351966 |
| Phone Number: | 9083619801 |
| Fax Number: | |
| NPI Enumeration Date: | 08/14/2008 |
| NPI Last Update Date: | 08/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 25MA08002100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |