Healthcare Provider Details

I. General information

NPI: 1316272685
Provider Name (Legal Business Name): DRX PARAMUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 E RIDGEWOOD AVE UNIT C
PARAMUS NJ
07652-3623
US

IV. Provider business mailing address

8 DEERHILL DR
HO HO KUS NJ
07423-1706
US

V. Phone/Fax

Practice location:
  • Phone: 201-262-2010
  • Fax: 201-262-2040
Mailing address:
  • Phone: 201-262-2010
  • Fax: 201-262-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number25MA08499300
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ROBERT W MALIZIA
Title or Position: MEDICAL DIRECTOR / OWNER
Credential: M.D.
Phone: 201-262-2010