LOYAL MEDICAL PC


Address: 1000 Edgewood Ln, Fort Lee, NJ 07024-4223
Phone: 2018868188

LOYAL MEDICAL PC (NPI# 1366833352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366833352
Entity Type Organization
Organization Name LOYAL MEDICAL PC
Practice Address 1000 Edgewood Ln
Fort Lee
NJ 07024-4223
Practice Telephone 2018868188
Practice Fax Number 2018868288
Mailing Telephone 2018868188
Mailing Fax Number 2018868288
Enumeration Date 2015-02-11
Last Update Date 2015-06-22
Authorized Official Name DR. MATSUKO TAKESHIGE (PRESIDENT)
Authorized Official Telephone 2018868818
Authorized Official Credential D.O.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
25MB09434100 NJ Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NJ 0460931 05

Office Location

Street Address 1000 EDGEWOOD LN
City FORT LEE
State NJ
Zip Code 07024-4223

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City FORT LEE
Zip Code 07024

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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