Provider Demographics
NPI:1013183961
Name:DR MATHIAS ZEMEL, LLC
Entity Type:Organization
Organization Name:DR MATHIAS ZEMEL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATHIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEMEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-279-1232
Mailing Address - Street 1:675 BROADWAY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1444
Mailing Address - Country:US
Mailing Address - Phone:973-279-1232
Mailing Address - Fax:
Practice Address - Street 1:675 BROADWAY
Practice Address - Street 2:SUITE 5
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1444
Practice Address - Country:US
Practice Address - Phone:973-279-1232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA040185174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ139442Medicare PIN