Provider Demographics
NPI:1003818881
Name:EZEMA, JAMES N (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:N
Last Name:EZEMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 NASHAWAY DR
Mailing Address - Street 2:
Mailing Address - City:RINGOES
Mailing Address - State:NJ
Mailing Address - Zip Code:08551-2056
Mailing Address - Country:US
Mailing Address - Phone:908-338-4626
Mailing Address - Fax:
Practice Address - Street 1:300 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2819
Practice Address - Country:US
Practice Address - Phone:973-266-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06308200207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6862004Medicaid
NJ853559UWWMedicare PIN
NJ853559DLEMedicare PIN
NJ853559UWXMedicare PIN
NJ6862004Medicaid
NJ853559P7DMedicare PIN
NJ853559CLDMedicare PIN
NJ853559AA7Medicare PIN
NJ853559MK3Medicare PIN
NJ853559TLMMedicare PIN
NJ853559DPKMedicare PIN
NJ853559P7EMedicare PIN
NJ853559P73Medicare PIN
P00424439Medicare PIN