FAMILY LEGACY MEDICAL CARE, PA (NPI# 1043704810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043704810 |
| Entity Type | Organization |
| Organization Name | FAMILY LEGACY MEDICAL CARE, PA |
| Practice Address |
115 Jefferson Ave Elizabeth NJ 07201-2417 |
| Practice Telephone | 9083516663 |
| Practice Fax Number | 9083511760 |
| Mailing Telephone | 9083516663 |
| Mailing Fax Number | 9083511760 |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2019-01-19 |
| Authorized Official Name | DR. PASCALE FERDINAND (PHYSICIAN) |
| Authorized Official Telephone | 9083516663 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | CAQH | 10655985 | 01 |
| NJ | CAQH | 14126510 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 60 Evergreen Pl, East Orange, NJ 070182106 | 9736750097 |
| Street Address |
115 JEFFERSON AVE |
| City | ELIZABETH |
| State | NJ |
| Zip Code | 07201-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770686289 | Michel-ange Ferdinand | Family Medicine | 115 Jefferson Ave, Elizabeth, NJ 07201 | 2006-09-07 |
| 1487067856 | Pascale Ferdinand | Family Medicine | 115 Jefferson Ave, Elizabeth, NJ 07201 | 2014-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861750 | Columbia Dental of Elizabeth Pa | Dentist | 151 Jefferson Avenue, Elizabeth, NJ 07201 | 2020-11-04 |
| 1154950657 | Real House Inc. | Clinic/Center | 1089-91 East Jersey Street, Elizabeth, NJ 07201 | 2020-04-06 |
| 1588226161 | Latika Patel | Student in an Organized Health Care Education/Training Program | 224 Williamson Street, Elizabeth, NJ 07201 | 2019-07-03 |
| 1598221830 | Trucare Pharmacy Inc. | Pharmacy | 838 E. Grand St, Elizabeth, NJ 07201 | 2019-02-12 |
| 1346762911 | Ronel Sajouste | Non-emergency Medical Transport (VAN) | 476 Adams Avenue, Elizabeth, NJ 07201 | 2017-07-14 |
| 1134649189 | Community Access Unlimitd Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 16-22 Jaques St, 3, Elizabeth, NJ 07201 | 2017-06-21 |
| 1881128932 | Rosemarie Nielson | Internal Medicine | 557 Adams Ave, 1f, Elizabeth, NJ 07201 | 2017-04-15 |
| 1467995910 | Lourdes E. Lherisson | Optometrist | 651 Kapkowski Rd., Ste. 1236, Elizabeth, NJ 07201 | 2016-11-30 |
| 1629442462 | Ong Care | Home Health | 1139 E Jersey St Ste 502, Elizabeth, NJ 07201 | 2015-11-17 |
| 1336486547 | Puerto Rican Org for Community Educational & Economic Development | Community/Behavioral Health | 1122 E. Grand St., Elizabeth, NJ 07201 | 2013-01-08 |
| Find all providers in zip 07201 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003446485 | Portercare Adventist Health System | Family Medicine | 240 Elizabeth St Ste B, Elizabeth, CO 80107-7546 | 2020-01-24 |
| 1427522564 | Sanitas Medical Center of New Jersey PC | Family Medicine | 240 Williamson St Ste 300&302, Elizabeth, NJ 07202-3674 | 2019-01-11 |
| 1487120226 | Harrison County Hospital | Family Medicine | 5855 N Hwy 111 Se, Elizabeth, IN 47119-9039 | 2018-10-19 |
| 1518191923 | Wirt County Health Services Association, Inc | Family Medicine | Schoolview Street, Elizabeth, WV 26143 | 2009-05-13 |
| 1003081076 | Raul Iluminado Perez | Family Medicine | 605 S Broad St Unit B, Elizabeth, NJ 07202-2601 | 2008-04-29 |
| 1598824054 | Elizabeth Family Medicine | Family Medicine | 121 N 2nd Ave, Elizabeth, PA 15037-1532 | 2006-12-08 |
| 1477654317 | Richard Dean Brown | Family Medicine | 5855 N Hwy 11 Se, Elizabeth, IN 47117 | 2006-09-25 |
| 1124124441 | Amilda Heckman | Family Medicine | 34061 Forest Park Dr, Elizabeth, CO 80107-7842 | 2006-09-15 |
| 1770686289 | Michel-ange Ferdinand | Family Medicine | 115 Jefferson Ave, Elizabeth, NJ 07201 | 2006-09-07 |
| 1992715825 | Ariel Quinones | Family Medicine | 38 Elmora Ave, Elizabeth, NJ 07202-2248 | 2006-08-09 |
| Find all providers in ELIZABETH | ||||
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| 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.