Ideal Family Health, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA064861 Issued in NJ

Legal business name

IDEAL FAMILY HEALTH, P.C.

Practice address

291 S Van Brunt St
Englewood, NJ 07631-4632

Phone

(201) 568-1300

Fax

(201) 568-1320

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marion Bobb-McKoy, M.D.

Title

Physician

Phone

(201) 568-1300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992827141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WOOD RD",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076321625",
            "telephone_number": "201-568-1300",
            "fax_number": "201-568-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 S VAN BRUNT ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314632",
            "telephone_number": "201-568-1300",
            "fax_number": "201-568-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL FAMILY HEALTH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOBB-MCKOY",
        "authorized_official_first_name": "MARION",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "201-568-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA064861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY LICENSE",
            "identifier": "MA064861",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.