Provider Demographics
NPI:1093120362
Name:EMERGIMED PC
Entity Type:Organization
Organization Name:EMERGIMED PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUAKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-945-6500
Mailing Address - Street 1:663 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-3012
Mailing Address - Country:US
Mailing Address - Phone:201-945-6500
Mailing Address - Fax:201-945-1157
Practice Address - Street 1:663 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-3012
Practice Address - Country:US
Practice Address - Phone:201-945-6500
Practice Address - Fax:201-945-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care