Healthcare Provider Details

I. General information

NPI: 1659309680
Provider Name (Legal Business Name): PLAINFIELD EMERGENCY PHYSICIANS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PARK AVE
PLAINFIELD NJ
07060
US

IV. Provider business mailing address

PO BOX 635087
CINCINNATI OH
45263-5087
US

V. Phone/Fax

Practice location:
  • Phone: 856-686-4316
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier2648948000
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerAMERIHEALTH
# 2
Identifier8419604
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: DR. MICHAEL D CALI
Title or Position: DIRECTOR
Credential: M.D.
Phone: 856-686-4342