Healthcare Provider Details

I. General information

NPI: 1568307049
Provider Name (Legal Business Name): EMMA BIRNEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 RICHMOND AVE
POINT PLEASANT BEACH NJ
08742-2550
US

IV. Provider business mailing address

407 3RD AVE APT 1A
ASBURY PARK NJ
07712-6074
US

V. Phone/Fax

Practice location:
  • Phone: 732-295-1331
  • Fax:
Mailing address:
  • Phone: 267-243-8999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MP01015200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: