Healthcare Provider Details

I. General information

NPI: 1700355807
Provider Name (Legal Business Name): MEDICAL ASSOCIATES OF ENGLEWOOD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2018
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ENGLE STREET
ENGLEWOOD NJ
07631
US

IV. Provider business mailing address

350 ENGLE ST
ENGLEWOOD NJ
07631-1808
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-3158
  • Fax:
Mailing address:
  • Phone: 201-894-3158
  • Fax: 201-894-0453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: HILLARY COHEN
Title or Position: MD
Credential:
Phone: 201-608-2136