Healthcare Provider Details

I. General information

NPI: 1942287883
Provider Name (Legal Business Name): HOBOKEN EMERGENCY PHYSICIANS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 WILLOW AVE HOBOKEN EMERGENCY PHYSICIANS
HOBOKEN NJ
07030-3808
US

IV. Provider business mailing address

3114 CROASDAILE DR STE 200 HOBOKEN EMERGENCY PHYSICIANS
DURHAM NC
27705-2508
US

V. Phone/Fax

Practice location:
  • Phone: 201-418-2065
  • Fax:
Mailing address:
  • Phone: 919-425-1565
  • Fax: 919-425-0478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MB06960500
License Number StateNJ

VIII. Authorized Official

Name: DR. STEVEN R SCOTT
Title or Position: PRESIDENT
Credential: MD
Phone: 919-425-1565