Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Medical & Surgical Family Practice of Passaic P A

Organization Surgery Physician · NPI 1457482614

Medical & Surgical Family Practice of Passaic P A is a Surgery Physician in Passaic, New Jersey. Licensed in New Jersey. Registered with an NPI since 2007.

Licensed in
NJ
In the registry since
2007
Specialties on file
3

Practice location Address checks out

121 Prospect St
Passaic, NJ 07055-4926
Phone: (973) 777-3006
Fax: (973) 777-5587
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 25MA04703100 (NJ)
Surgery Physician Taxonomy 208600000X · Licence 25MA04703100 (NJ)
Vascular Surgery Physician Taxonomy 2086S0129X · Licence 25MA04703100 (NJ)

Record details

NPI number1457482614
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carlos Tello — Medical Director · (973) 777-3006
NPI enumeratedMarch 8, 2007
Last updated in NPPESMarch 6, 2017
Mailing addressPo Box 2007, Paterson, NJ 07509-2007

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