Healthcare Provider Details

I. General information

NPI: 1760515860
Provider Name (Legal Business Name): EMPIRE MEDICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 11/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 FRANKLIN AVE SUITE 302
BELLEVILLE NJ
07109-3532
US

IV. Provider business mailing address

5 FRANKLIN AVE SUITE 302
BELLEVILLE NJ
07109-3532
US

V. Phone/Fax

Practice location:
  • Phone: 973-759-1221
  • Fax: 973-759-1997
Mailing address:
  • Phone: 973-759-1221
  • Fax: 973-759-1997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: NADER MOAVEN
Title or Position: PRESIDENT
Credential: MD
Phone: 973-759-1221