Healthcare Provider Details

I. General information

NPI: 1336181692
Provider Name (Legal Business Name): MEADOWLANDS EMERGENCY DEPARTMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MEADOWLANDS PKWY
SECAUCUS NJ
07094-2977
US

IV. Provider business mailing address

484 TEMPLE HILL RD
NEW WINDSOR NY
12553-5529
US

V. Phone/Fax

Practice location:
  • Phone: 201-392-3210
  • Fax:
Mailing address:
  • Phone: 845-565-3700
  • Fax: 845-565-3395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW W ROBUSTELLI
Title or Position: PRESIDENT
Credential: MD
Phone: 845-565-3700