Healthcare Provider Details

I. General information

NPI: 1922349992
Provider Name (Legal Business Name): ER EXPRESS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24-19 BROADWAY
FAIR LAWN NJ
07410-3053
US

IV. Provider business mailing address

24-19 BROADWAY
FAIR LAWN NJ
07410-3053
US

V. Phone/Fax

Practice location:
  • Phone: 973-839-1003
  • Fax: 973-839-3653
Mailing address:
  • Phone: 201-475-4000
  • Fax: 201-475-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS HOLDEN
Title or Position: OWNER
Credential: MD
Phone: 201-475-4000