Provider Demographics
NPI:1629396130
Name:CENTER CITY FAMILY MEDICINE, LLC
Entity type:Organization
Organization Name:CENTER CITY FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YLONKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-MAROTTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-818-1213
Mailing Address - Street 1:363- 21 ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501
Mailing Address - Country:US
Mailing Address - Phone:973-818-1213
Mailing Address - Fax:973-881-0049
Practice Address - Street 1:363 21ST AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-3640
Practice Address - Country:US
Practice Address - Phone:973-818-1213
Practice Address - Fax:973-881-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-07
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08389400261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care