Revoredo, Fred
Revoredo, Fred is an sole proprietor health care provider with primary practice located at 425 15Th Ave , Paterson NJ 07504-1811. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Revoredo, Fred can be contacted via phone (973) 345-4155.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25MA07147400 | New Jersey |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 25MA07147400 | New Jersey |
Profile Details
| NPI number | 1669588422 |
|---|---|
| LBN Legal business name | Revoredo, Fred |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 22nd, 2006 |
| Last updated | Sep 9th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669588422 | NPPES |
| New Jersey | MEDICAID | 8376808 |
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