Atco Family Medical Associates, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB01786500 Issued in NJ

Legal business name

ATCO FAMILY MEDICAL ASSOCIATES, PC

Practice address

10 Gardens Avenue
Berlin, NJ 08009-2104

Phone

(856) 767-1026

Fax

(856) 768-9577

NPI assigned

Mar 10, 2008

Last updated

Sep 15, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marvin S Wallach, D.O.

Title

Owner/Physician

Phone

(856) 767-1026

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1306016050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GARDENS AVENUE",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080092104",
            "telephone_number": "856-767-1026",
            "fax_number": "856-768-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GARDENS AVENUE",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080092104",
            "telephone_number": "856-767-1026",
            "fax_number": "856-768-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATCO FAMILY MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "WALLACH",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "856-767-1026",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB017865",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB01786500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.