Provider Demographics
NPI:1518932938
Name:EDMUND C. TOPILOW,MD,FACS,PA
Entity Type:Organization
Organization Name:EDMUND C. TOPILOW,MD,FACS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF MY CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:TOPILOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-436-8596
Mailing Address - Street 1:796 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-5839
Mailing Address - Country:US
Mailing Address - Phone:201-436-8596
Mailing Address - Fax:201-436-7867
Practice Address - Street 1:796 AVENUE C
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-5839
Practice Address - Country:US
Practice Address - Phone:201-436-8596
Practice Address - Fax:201-436-7867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04010900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2685001Medicaid
NJ2685001Medicaid
NJC59463Medicare UPIN