Healthcare Provider Details

I. General information

NPI: 1568791192
Provider Name (Legal Business Name): ST. JOSEPH'S EMERGENCY PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 MAIN ST EMERGENCY DEPARTMENT
PATERSON NJ
07503-2621
US

IV. Provider business mailing address

35 ACKERMAN AVE
CLIFTON NJ
07011-1501
US

V. Phone/Fax

Practice location:
  • Phone: 973-754-2000
  • Fax: 973-754-4574
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ALWELL
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 973-754-2136