Provider Demographics
NPI:1417637380
Name:EMD ENGLEWOOD, LLC
Entity Type:Organization
Organization Name:EMD ENGLEWOOD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NARPAT
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-501-8282
Mailing Address - Street 1:323 E MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-1743
Mailing Address - Country:US
Mailing Address - Phone:201-981-1260
Mailing Address - Fax:
Practice Address - Street 1:460 ENGLE ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1829
Practice Address - Country:US
Practice Address - Phone:201-501-8282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty