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General NPI Number Information
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NPI Number | 1952097156
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Entity Type | Organization
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Legal Business Name | EAST RIVER MEDICAL ASSOCIATES OF NEW JERSEY PC
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 400 FRANKLIN TPKE STE 200
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City | MAHWAH
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State | NJ
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Zip | 07430-3518
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Country | US
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Telephone | 201-267-7000
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Fax | 201-267-9799
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Provider Business Mailing Address
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Address Line | PO BOX 626
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City | GREAT RIVER
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State | NY
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Zip | 11739-0626
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Country | US
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Telephone | 631-892-2745
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Fax | 631-201-3179
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS S. WETMORE
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Credential | MD
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Telephone | 201-267-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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