Provider Demographics
NPI:1104529452
Name:FAMILY CARE MD LLC
Entity type:Organization
Organization Name:FAMILY CARE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIUHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:862-438-0684
Mailing Address - Street 1:76 W MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2148
Mailing Address - Country:US
Mailing Address - Phone:732-637-5292
Mailing Address - Fax:732-637-5299
Practice Address - Street 1:76 W MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2148
Practice Address - Country:US
Practice Address - Phone:732-637-5292
Practice Address - Fax:732-637-5299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty