Provider Demographics
NPI:1063976850
Name:MULTICULTURAL MEDICAL OFFICE LLC
Entity type:Organization
Organization Name:MULTICULTURAL MEDICAL OFFICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELING
Authorized Official - Middle Name:
Authorized Official - Last Name:DILONE-ARELLANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-439-1396
Mailing Address - Street 1:614 BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:716 BROAD ST STE 1B
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1645
Practice Address - Country:US
Practice Address - Phone:603-320-7378
Practice Address - Fax:973-777-7132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty