Dr. Fred Revoredo, MD
Family Medicine in Paterson, New Jersey
1669588422- Practice location
- 425 15TH Ave, Paterson, NJ 07504-1811
- Phone
- 973-345-4155
- Fax
- —
- Last updated
- July 29, 2024
Fred Revoredo is a Family Medicine based in Paterson, NJ. Fred Revoredo practices in Paterson, NJ and has the professional credentials of MD. The NPI Number for Fred Revoredo is 1669588422 and holds a License No. 25MA07147400 (NJ). The current practice location address for Fred Revoredo is 425 15TH Ave, Paterson, NJ 07504-1811 and can be reached out via phone at 973-345-4155.
Provider Profile Details
- NPI Number
- 1669588422
- Provider Name
- Fred Revoredo
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 425 15TH Ave, Paterson, NJ 07504-1811
- Phone Number
- 973-345-4155
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- August 22, 2006
- Last Update Date
- July 29, 2024
- Certification Date
- July 29, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 425 15TH Ave
Paterson, NJ 07504-1811 - City
- Paterson
- State
- New Jersey
- Zip
- 07504-1811
- Phone Number
- 973-345-4155
Provider Business Mailing Address Details
- Address
- 425 15TH Avenue
Paterson, NJ 07504-1811 - City
- Paterson
- State
- NJ
- Zip
- 07504-1811
- Phone Number
- 973-345-4155
License Information
- License Number (1)
- 25MA07147400
- License State (1)
- NJ
- Taxonomy (1)
- Emergency Medicine · 207P00000X
- License Number (2)
- 25MA07147400
- License State (2)
- NJ
- Taxonomy (2)
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Fred Revoredo, MD?
The NPI number of Dr. Fred Revoredo, MD is 1669588422. It was assigned on August 22, 2006 and is currently active in the NPPES registry.
What is the specialty of Dr. Fred Revoredo, MD?
Dr. Fred Revoredo, MD is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in NJ under license number 25MA07147400.
Where does Dr. Fred Revoredo, MD practice?
The practice location is 425 15TH Ave, Paterson, NJ 07504-1811. The office can be reached at 973-345-4155 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1669588422 directly on the NPPES registry website.