Healthcare Provider Details

I. General information

NPI: 1497783419
Provider Name (Legal Business Name): EMERGENCY PHYSICIAN ASSOCIATES OF NORTH JERSEY P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 BEAUVOIR AVE
SUMMIT NJ
07901-3533
US

IV. Provider business mailing address

PO BOX 635551
CINCINNATI OH
45263-5551
US

V. Phone/Fax

Practice location:
  • Phone: 908-522-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN MURTAUGH
Title or Position: VICE PRESIDENT
Credential:
Phone: 856-848-3817