Provider Demographics
NPI:1376545897
Name:MARGOLIS, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:MARGOLIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:
Practice Address - Street 1:663 PALISADE AVE STE 304
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:201-313-1933
Practice Address - Fax:201-313-9599
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06410400208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ53T591OtherEMPIRE BC/BS (ENGLEWOOD)
NJP406621OtherOXFORD #
NJ2356155OtherAETNA HMO #
NJ340015151OtherRAILROAD MDCR #
NJ53T592OtherEMPIRE BC/BS (CLIFFSIDE)
NJ0990766000OtherAMERIHEALTH
NJ5290504OtherAETNA PPO #
NJ7005008Medicaid
NJ0K7855OtherHEALTHNET #
NJ1099196OtherGHI PPO
NJ5290504OtherAETNA PPO #