Provider Demographics
NPI:1063652220
Name:EXCEL URGENT CARE OF PARAMUS LLC
Entity Type:Organization
Organization Name:EXCEL URGENT CARE OF PARAMUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-265-9500
Mailing Address - Street 1:484 TEMPLE HILL RD
Mailing Address - Street 2:STE 104
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-5557
Mailing Address - Country:US
Mailing Address - Phone:845-565-3700
Mailing Address - Fax:845-565-3395
Practice Address - Street 1:110 RIDGEWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-265-9500
Practice Address - Fax:845-565-3395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ158069Medicare PIN