=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083543847
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMAUS SPECIALTY CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2026
-----------------------------------------------------
Last Update Date | 05/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19 VILLA PL
-----------------------------------------------------
City | NUTLEY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07110-1919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-312-8448
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19 VILLA PL
-----------------------------------------------------
City | NUTLEY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07110-1919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-312-8448
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PA/OWNER
-----------------------------------------------------
Name | EMAUS SANTIAGO
-----------------------------------------------------
Credential | PA
-----------------------------------------------------
Telephone | 516-312-8448
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------